Category Archives: Vitamins and supplements

Shilling for Big Herba

All drugs are bad, in any amount. All vitamins, supplements and other SCAM products are good, and the more the better.

That’s the message of WDDTY, brought to you by the advertising budgets of people selling vitamins, supplements and SCAM products.

Sunshine News #1: You’re only getting a tenth of what you need

No, you really aren’t. Unless you want skin cancer. What WDDTY actually want to sell you is pills. It must be pills: they say that sunscreen is carcinogenic, so they cannot possible be advocating more sun exposure, because that would be a literally murderous level of stupid.

People who have been following the RDA (recommended dietary allowance) amounts for vitamin D could be severely malnourished: scientists have discovered the recommendation is only one-tenth of what it needs to be.

Really?

The current RDA forthe vitamin is 600 IU/ day for everyone up to the age of 70, and 800 IU/dayforthose who are older. But a team of American researchers, in response to a letter by a pair of Canadian
researchers calling on all public-health groups and agencies to urgently change the current too-low RDA for vitamin D, say the
amount we really should be getting from all sources, including sunshine, is 7,000 IU/day.

Doses that large are normally promoted by the “orthomolecular” quacks. Who are these scientists and researchers?

We have a source: Nutrients, 2015; 7: 1688-90.  The first thing to note about this is that it is not a published article, it’s a letter. WDDTY readers probably don’t know the difference. Letters do not go through peer review, they are simply expressions of opinion.

The letter responds to another letter, again not a paper. Both are contingent on an estimate of appropriate serum levels of 25-hydroxyvitamin D. The letters are estimates based on regressions – they suggest a need for further research, theya re not a confident finding, and they are absolutely not a cast-in-stone fact, as WDDTY promotes them

And even this amount is way below the safe upper limit for teenagers and adults, which may be as high as 10,000 IU/day, says Cedric Garland of the University of California at San Diego.

Garland is a darling of the orthomolecular crowd.

In fact this adds very little to what is already known: that people living in Northern latitudes may, in later life, require vitamin D supplementation.

The idea that large amounts of supplemental vitamin D are essential to life in the otherwise healthy adult human, is evolutionarily improbable and unsupported by data.

Amazon ban on – sorry, sales of – herbal products “illegal” – sorry, illegal.

amazonCall the police! A shrieking headline says:

Amazon ban on herbal products ‘illegal’

Wow, really? Let’s look a little closer:

The online retailer Amazon has pulled more than a hundred St John’s wort products, a herbal remedy for depression, after it was approached by the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA).

So the statutory regulatory body approached Amazon, and Amazon pulled the products. And this is supposedly illegal. According to whom? Let’s read on:

The campaign group, the Alliance for Natural Health (ANH),
says the MHRA “overstepped the legal mark” and some of those
107 products should never have been removed.

Oh really. And there’s not quite enough space to note that WDDTY contributor Rob Verkerk is the founder of the ANH, or point out that this is a body founded to promote the interests of the supplement industry, which profits handily from bullshit claims for products like St John’s Wort.

Follow the money. Unless it’s going to your friends.

The MHRA says the products were unlicensed and making
illegal medicinal claims or were inappropriately labelled. It now
plans to contact other on line retail outlets, including eBay, which have been supplying the products.

Statutory regulator enforces regulations shock. Pictures at eleven.

Amazon had two choices: challenge the request, or accede. Amazon chose to accede tot he request. They have lawyers and a metric fuckton of money, so that rather suggests that they accept the MHRA’s view that the marketing claims were illegal and the products were unlicensed.

It’s understood the MHRA acted after being approached
by the Health Food Manufacturers’ Association (HFMA) last
December. The association’s executive director Graham Keen
has described the action as having “a very positive outcome”.

So even some of those selling natural woo, are pissed off by the fraudulent claims of other marketers of natural woo. Interesting.

But the ANH questions the “legitimacy of the forced
product removal” and says that some of the medicinal claims
are “carefully worded health claims that are as yet not nonauthorized by the European Commission”.

Does Rob Verkerk work for the Ministry of Truth? That is some amazing doublespeak there.

It says this latest ban is part of an “ongoing campaign by the
MHRA to attack herbal food supplements without adequate
legal justification”.

Skeptics will be rolling around on the floor laughing at this: the MHRA is notoriously spineless in challenging the dubious claims of natural-woo scammers, this is incredibly rare and is based on clear-cut and flagrant breaches of the law.

How happy would WDDTY be for Big Pharma to sell products with unapproved claims via Amazon, do you think? Answers on a postcard, please.

2822 PubMed hits say the medical establishment is not “ignoring” B12

According to a callout in the January 2015 story punting Vitamin B12 as a miracle cure for all ills (and bigging up Brave Maverick Doctor Joseph Chandy),

The Medical Establishment has chosen to ignore the evidence on B12 as an inexpensive and promising answer to depression

If only there was a quick and easy way to check that claim for accuracy.

Wait! There is! A PubMed search. 2822 results. OK, not all will necessarily be relevant, but this is hardly “ignoring” it.

That said, there is a very substantial difference between the cautious claims of scientists and the bold and striking claims of Dr. Chandy.

Several nutritional and physiological factors have been linked to depression in adults including low folate and vitamin B-12 and elevated total homocysteine (tHcy) levels. (source)

These symptoms are common in undiagnosed coeliacs, where they are effects of an underlying disease, markers, not necessarily causes. B12 and folate deficiency are very often the result of malabsorption in patients with autoimmune disorders such as coeliac and Crohn’s, where the gut wall is compromised.

Conclusions: Future interventions aiming at improving mental health outcomes among US adults should take into account dietary and other factors that would increase levels of serum folate.

Damn, they missed the ball. They could have sold vitamin B12 pills to self-diagnosing worried-well patients. These scientists, they are so off message it’s untrue.

 

Banning B12

WDDTY has a bit of a downer on the medical establishment, especially since they struck off Andrew Wakefield on the ridiculously flimsy basis that he conducted unapproved invasive tests on vulnerable children, concealed conflicts of influence and published fraudulent research.

So it’s not a surprise to find them championing the cause of Dr. Joseph Chandy, a GP who discovered dreamed up the idea that Vitamin B12 deficiency is the cause of anaemia, multiple sclerosis, dementia, depression, confusion, myalgic encephalomyelitis chronic fatigue syndrome, migraine, tinnitus, neuralgia and (of course!) autism.

One of the hallmarks of quackery is that it claims to cure a vast range of completely different diseases. And one of the other hallmarks of quackery is that it gets you in trouble with the GMC.

The trouble with WDDTY’s narrative here is that it depends on the idea that the medical establishment would act against someone promoting a cheap and effective cure for numerous diseases, in order to protect pharmaceutical industry profits. The alternative, that he has failed to produce credible evidence to back his treatment decisions and that he is a lone voice because he is wrong, is not considered – or if it is, it is rejected, because WDDTY wants to believe that a vitamin can cure these diseases.

Sadly, science doesn’t tend to reward wishful thinking (regardless of how assiduously Lynne tries to prove otherwise with her “intention experiment”.

Luckily for Chandy, if the Saatchi Bill passes, mavericks who promote treatments with no evidence and no support from the wider medical and scientific community will be allowed to prey on patients provided they are especially vulnerable to predation.

You might want to stop that happening.

New supplement best for preventing bone loss, says study

Churnalism. Don’t you just love it? The repetition of self-serving claims from press releases into press as if they were facts. Wikipedia calls this “fact-washing”.

WDDTY said they would not do this. It’s as true as their principled statement that they would never take paid advertising.

So it’s no surprise to see a tweet from WDDTY:

new-supplement

We know WDDTY well enough by now to be able to read the subtext. A new supplement (i.e. made by the whiter-than-snow big-pharma-suppressed all-natural supplement world) is superior to the current drugs.

And this is clear too in the story they link:

A new nutritional supplement is better than calcium and vitamin D for protecting the bones in older women, a new study has concluded.

There you have it: the supplement is better than the drug calcium and vitamin D. Except – wait – that’s a supplement too isn’t it? How can this be? Ah yes: calcium and vitamin D, usually branded Adcal or Calcichew, is made by big pharma.

KoACT is a calcium-collagen chelate—which means the two compounds are bound together—that prevents bone loss, and so reduces the risk of osteoporosis and fractures.

Well that’s plausible enough, but it rather runs against the narrative as the calcium-collagen chelate is produced by a pharmaceutical manufacturing process; the supplement is a form that does not actually exist in nature.

It’s been tested for a year on 39 older women, who were given either KoACT or calcium and vitamin D supplements. Women in the KoACT group had a 1.23 per cent loss in bone mineral density at the end of the 12 months trial, while those taking the supplements experienced a 3.75 per cent loss.

N=39 is a very small study. The difference in bone loss could be significant, or it might not.

Researchers from Florida State University, who carried out the study, say the results are “crucial” for women, and especially for those who have reached the early stages of menopause when bone loss can be rapid.

Do they indeed? Or is it, perhaps, that these words were planted in their mouths by someone?

You know what’s coming. You will have guessed the obvious right from the outset. But I won’t spoil your pleasure yet.

KoACT website: www.koact.net

(Source: Journal of Medicinal Food, 2014; 141014082953002).

Want to see that source? You bet. The journal link is  doi:10.1089/jmf.2014.0100 and it’s also summarised in Science Daily.

The Science Daily coverage is more comprehensive, giving a more neutral overview and not including claims that the results are “crucial” but instead the much more plausible:

Arjmandi acknowledged he was “pleasantly surprised” by the outcomes and hopes that the supplement will be used in the future as a way to prevent bone density loss.

And now the moment you’ve all been waiting for. There, at the bottom of Science Daily’s article is the one piece of genuinely crucial information, the essential fact omitted from WDDTY which necessarily colours any interpretation of this small, preliminary study:

Arjmandi’s study was funded by AIDP, Inc.

And AIDP Inc. is, of course, the manufacturer of the supplement.

What Doctors Don't Tell You
Why don’t doctors tell you that a calcium/collagen chelate is more effective for preventing bone loss than calcium and vitamin D?

Because the evidence to date is one rather small study funded by the manufacturer.

The Vitamin Wars

Few columns in WDDTY reveal the hypocrisy of the SCAM industry quite so consistently as Rob Verkerk’s. Rob runs the Alliance for Natural Health Europe (ANH-Europe), a SCAM industry lobby group indistinguishable in function and purpose from the lobbying companies used by “big pharma”, but far less scrupulous when it comes to accuracy, because Rob (like many of his contemporaries) not only lobbies for SCAM, he also makes money from SCAM, and makes more money promoting in print the SCAM from which he makes money.

His February 2014 is perfect of its type:

Few Natural-health aficionados would have been unable to miss the media reports about vitamins being a waste of money. They hit every major newspaper, radio and TV station last December.

Yes, it’s a welcome change from the usual credulous nonsense planted by people like Rob Verkerk.

The Times’ science correspondent, Tom Whipple, the journalist that has had his crosshairs focused on this very magazine in separate articles appearing on the 1st October and 2nd November, was the most condemning.

No evidence that Tom Whipple was the most condemning, but to say he has his crosshairs focused on WDDTY is a classic appeal to motives: according to Verkerk, Whipple cannot be trusted because he has an agenda against WDDTY. In fact, the opposite is true: Whipple can be trusted precisely because he has spoken out against the misleading information in WDDTY, rather than either parroting it or ignoring it as most journalists do.

Rob Verkerk, like Lynne McTaggart and all the other contributors to WDDTY, is unable to separate objective scrutiny of false information from suppression of free speech. That’s because they sincerely believe things which are unsupported by scientific evidence, and that’s precisely why any trustworthy health journalist will give overwhelmingly negative coverage to WDDTY.

His piece, in the 17th December edition of the newspaper, declared, “Vitamin pills are a waste of money, experts warn.” The Daily Mail said multivitamins “do nothing to protect us from illness”.

And this is true: for most people eating a healthy balanced diet, supplements are unnecessary. And for those who are not eating a healthy balanced diet, a change of diet is vastly preferable to supplementation.

So who are those experts, and what did they actually reveal or say? The first thing to recognize is that the most damning headlines about vitamin and mineral supplements weren’t generated from any new clinical trials or even analyses of previous trials. They actually came from an opinion piece written as an editorial by a number of scientists and appearing in the same issue of the medical journal Annals of Internal Medicine (AIM) that also included three reviews of past studies. Some of the authors had been engaged in previous studies of high-dose synthetic vitamin supplements.

Apparently Rob Verkerk doesn’t understand the process of scientific consensus building. This article summarised several reviews and other evidence, and drew a conclusion. That’s what science does. It’s interesting, though, that a columnist in WDDTY would try to play the “appeal to authority fallacy” card to undermine a published paper – great swathes of WDDTY would be blank if the editors adopted the view that appeals to authority are not reliable.

But this was a serious, highly credible, well-researched article in a major  peer-reviewed journal. That’s why it is so important, and why Verkerk has to spin like crazy to downplay it.

One review, the biggest by far, evaluated 26 studies to see if there was a link between taking typical dosages and forms of multivitamin/ mineral supplements and death from any cause, as well as death from either cancer or heart disease.

Another looked at two studies that evaluated the effects of a multivitamin on reducing cognitive decline in the elderly, and the third investigated whether a multivitamin could reduce cardiovascular events among those who’d already had a heart attack.

Indeed. And the results were underwhelming to say the least.

Any clinicians worth their salt and practising in the field of nutritional medicine, if asked to propose the likely outcomes of the multivitamin interventions evaluated by the three AIM articles, would have said “no chance”. And guess what? That’s just what was found. But this then gave the editorial authors a chance to blast their anti-supplement sentiments through an opinion piece that generated international news headlines.

A physician worth their salt and practising in the field of nutritional medicine, is called a dietician. It’s a protected title, and practitioners are subject to training requirements and statutory regulation. And yes, they would say that the chances of a positive result from precisely the kinds of routine supplementation that makes millions for the SCAM industry in product sales is slim. Multivitamins are, as the article says, probably a complete waste of money. How many shelves in your local pharmacy would that empty?

It’s big business. And the business needs its spin machine – including mouthpieces like Verkerk – to undermine a finding that is in the end neither surprising nor controversial.

The anti-supplement machine is rather well oiled and appears to be wheeled out every couple of years or so, presumably to try to dissuade people from doing too much to manage their own health. Short of banning supplements—something already happening especially within the EU and causing us to lose some of the most efficacious products, which threaten drug sales—this appears to be the favoured strategy among those with this particular agenda.

The pharma shill gambit rides again. What “anti-supplement machine”? When was the last time you saw an advertisement telling you not to buy supplements? When did you last see a campaign to stop shops selling supplements? Who is behind this “anti-supplement machine”? Certainly not “big pharma”, as they own many supplement brands. Whoever it is, they are doing a startlingly inept job: supplements are everywhere, touted by all kinds of credible-looking people using sciencey-sounding words, and they are getting away with it. Nearly a third of the UK population are popping supplements, and according to the evidence they are mainly worthless. That’s not evidence of a well-oiled anti-supplement machine is it?

The statement that this is “presumably to try to dissuade people from doing too much to manage their own health” is an appeal to motives; what Verkerk really means is that promotion of good science (i.e. science talking down the benefit of supplementation) is designed to dissuade people from giving unnecessary money to him, and others like him. The whole point of recent activity around regulatory changes is precisely that people are not managing their own health by taking supplements, they are mainly handing money to charlatans. Hence controls on maximum doses, to provide some control over vitamin megadoseW quacks.

What you don’t read in the papers is what was actually found in the studies. Did you read that a simple multivitamin can lower cancer risk in men by 8 per cent? You probably didn’t read that there were many studies that found positive effects. It’s just when you pool studies that have conflicting results, the very nature of a systematic review of this type, that you run the risk of cancelling out the variable results, even when they may have been due to other factors.

The whole point of a systematic review is that it balances the chance positive findings inevitable in clinical studies, and finds the overall effect to a much greater degree of certainty. As with homeopathy, the number of positive studies is completely irrelevant to the consensus of review studies that there is no credible evidence of effect. The positive studies are not ignored by systematic reviews, they are assessed, weighted according to methodological quality, and factored into the mix.

When the summary finding is no benefit, there’s no point howling about the positive results. The systematic review has already taken account of them. That is, after all, the point.

Also conspicuously absent from the news reports was any discussion of the reasons why most people take a daily multivitamin. They do so because of perceived benefits regarding things like energy levels, athletic performance, mental alertness and immune support.

Really? Where do they get this perception of benefit, given that the reviews find no actual benefit? Ah, wait: it’s a placebo effect caused by people like Verkerk talking up the clinically indefensible products from which he makes such a nice living.

In fact, many of these kinds of relationships have actually been proven scientifically, and have been officially authorized as health claims for use on commercial products EU-wide by the European Food Safety Authority (EFSA), the EU’s highest authority on food safety.And the EFSA is notoriously tough on accepting health claims. They’ve only approved about 250 in total, and most of these are for vitamins and minerals.

Not strictly true, since these approvals often rely on subjective assessments of benefit, but why would this be a problem? If the evidence is there, then the product is licensed and can be sold. If it’s not, then the evidence isn’t there. Verkerk appears to be arguing that because EFSA approves other products of this class, albeit not many, then all products of the class should be sold as if they were covered. Why would that be a good idea?

Another point made in the AIM editorial is that people can get everything they need from their diet.

Well, I agree. But only in theory, or in relation to a tiny section of society who are able to put in huge amounts of effort to source and prepare the best highest-quality foods and eat them consistently, day in, day out.

That is a fantastically implausible claim, and actually it’s the Nirvana fallacy. It is not hard to eat a balanced diet, and if it were then we’d scarcely have survived the harsh evolutionary realities of life. It doesn’t have to be the absolute best (either as defined by dieticians or quack nutritionists), it only has to be good enough.

The idea that a normal diet is substantially deficient in nutrients, is self-evidently bizarre. Vitamins were essentially unknown prior tot he late 18th Century and there is little doubt that the nutritional quality of our diet has improved vastly since then due to refrigeration and other techniques to prevent spoilage.

In practice, many of us fall dismally below optimal levels in one or more nutrients, and population-wide surveys show us that deficiencies in vitamin A (for immunity), vitamin K (for bone health), magnesium (for muscles and energy) and zinc (for immunity) are rampant. Worse than this, many of us carry genetic defects, referred to as ‘single nucleotide polymorphisms’ (SNPs), which mean we benefit from taking above average levels of particular nutrients to compensate. None of this gets a mention of course, despite the fact that this area of nutritional science— nutrigenomics—is one of the most rapidly expanding areas today.

This is a great argument for eating better and a truly terrible argument for buying a product which, according to the evidence, is routinely mis-sold by its proponents.

It seems that newspapers like The Times can only get away with creating headlines out of these issues if they are highly selective about the ‘facts’ and omit doing justice to the commonly accepted principles of standards of journalism and critical, unbiased reporting. I’m confident that most insightful readers will have been able to read past the agenda of the scientists and journalists involved.

You “forgot” to show that they were in the least bit selective. They didn’t toe the vitamin peddlers’ line, but that is a point in their favour rather than against them

What Doctors Don't Tell You
Why don’t doctors tell you to take supplements instead of eating a reasonable balanced diet?

Because doctors, unlike vitamin peddlers, care about your health, not their profits.

Kefir

The February 2014 issue is really one long advertorial for kefir. It’s dairy, Jim, bit not as we know it: while dairy is denounced as “cancer food“, this is, apparently, completely different. Because probiotic.

This is how to make kefir:

Basic kefir
You can use the method below to make any amount of kefir you desire; just keep in mind that a good rule of thumb is to use 1 Tbsp of kefir grains per cup of milk. So if you want to make 1 cup of kefir, use 1 Tbsp of kefir grains and 1 cup of milk. For 2 cups of kefir, use 2 Tbsp of kefir grains and 2 cups of milk, and so on.
Step 1: Place the kefir grains in a glass jar that can be securely sealed. I like canning jars with plastic lids, but you can use any jar that closes securely.
Step 2: Using the 1 Tbsp to 1 cup ratio of kefir grains to milk, add the appropriate amount of milk to the jar.
Step 3: Securely seal the jar, and leave it on your kitchen counter away from direct sunlight or in a cabinet at room temperature for 24 hours.
Step 4: After 24 hours, remove the kefir grains using a slotted spoon or mesh strainer. (The strainer can be stainless steel or plastic.) Add the kefir grains to fresh milk to begin another fermentation or for storage.
Step 5: Transfer the strained kefir to your refrigerator. At this point, it is ready to use. You can keep kefir in your fridge in a sealed container for up to one year. But remember, the longer it’s in the fridge, the more sour it will become because the bacteria eat the lactose in milk.

Eurgh. On to the claims.

Let’s look at one small section:

1 Stimulates the immune system. Peptides formed during fermentation or digestion appear to do the job, at least in animal studies.

Reference 1: J Dairy Sci, 2002; 85: 2733–42; Matar C et al. ‘Biologically active peptides released in fermented milk: role and functions’, in Farnworth ER, ed. Handbook of Fermented Functional Foods. Boca Raton, FL: CRC Press, 2003: 177–201

Interestingly, WDDTY appear to be starting to give some full citations, making it much easier to verify whether they have correctly represented the sources. In this case we have a legitimate source, an early study (therefore likely false), but fact-washed via a book by a nutritionist. The claims of nutritionists are, of course, always questionable, and the original source is available; it’s not clear why this indirect sourcing has been done, unless Lynne McTaggart has been reading a book proselytising kefir and is simply regurgitating the nonsense in WDDTY (which on the evidence does seem very likely).

In the last dozen years, why has this finding not been confirmed?

2 Stops tumour growth. Although most dairy products have been implicated in the promotion of prostate and other cancers, a polysaccharide isolated from kefir grains, whether in cow or soy milk, appears to inhibit a variety of tumours, including lung cancer cells and melanoma—again in animal studies.

Reference 2a: Jpn J Med Sci Biol, 1983; 36: 49–53; 

The original paper is hard to trace, no doubt because it is not in translation. It is a 30-year-old animal study. Your starter for ten and no conferring: what is the term for thirty-year-old findings of anti-cancer activity not confirmed in later work in mainstream journals specialising in cancer research? Yes: Likely false.

Reference 2b: Immunopharmacology, 1986; 12: 29–35; Immunopotentiative effect of polysaccharide from Kefir grain, KGF-C, administered orally in mice Mitsugu Murofushi, Junichiro Mizuguchi, Kageaki Aibara, Tyoku Matuhasi.

Reference 2c: J Agric Sci Tokyo Nogyo Daigaku, 2000; 45: 62–70

This source is not PubMed indexed, nor would I expect it to be – medical articles are not commonly published in journals of agricultural science.

All three of these seem to be drawn second hand from Farnworth, as with the first reference. There is a dearth of confirming evidence.

3 Allows better digestion and tolerance of lactose in the lactose-intolerant. Gassiness and digestion has been improved in both animals and humans given kefir.

Reference 3: J Am Diet Assoc, 2003; 103: 582–7  Kefir improves lactose digestion and tolerance in adults with lactose maldigestion. Hertzler SR, Clancy SM.

Why would this matter? According to WDDTY, dairy (other than kefir) is “cancer food”.

4 Improves digestion generally. Studies in animals show that regularly consuming kefir helps bacteria in the bowel grow significantly.

Reference 4: Lett Appl Microbiol, 2002; 35: 136–40 Dietary influence of kefir on microbial activities in the mouse bowel. Marquina D, Santos A, Corpas I, Muñoz J, Zazo J, Peinado JM

This would not be a surprise (it applies to all probiotics, after all), but why another ancient animal study from a dozen years back?

5 Provides a natural antibiotic. Kefir has been shown to inhibit E. coli and Streptoccocus bacteria.

Reference 5a: J Food Prot, 2000; 63: 364–9; Inhibitory power of kefir: the role of organic acids. Garrote GL, Abraham AG, De Antoni GL.

Reference 5b: Lebensm Wiss Technol, 2004; 37: 663–7; Determination of some characteristics coccoid forms of lactic acid bacteria isolated from Turkish kefirs with natural probiotic. Yüksekdag Z.N., Beyatli Y., Aslim B.

Reference 5c: Indian Vet J, 01/2004; 81: 687–90; 

Again we have studies in vitro and in animals – and from some time back. Why? There is credible evidence that kefir grown on milk infected with e.coli may induce resistance to e.coli, and there are credible reasons why this might be, but there’s no indication that this is inherent to all kefir, only to that grown in an infected medium.

6 May help reduce cholesterol. Small studies show that blood triglycerides are lower and good high-density lipoprotein (HDL) cholesterol slightly increased in those consuming kefir compared with milk
for four weeks.

Reference 6: BMC Complement Altern Med, 2002; 2: 1 Kefir consumption does not alter plasma lipid levels or cholesterol fractional synthesis rates relative to milk in hyperlipidemic men: a randomized controlled trial [ISRCTN10820810]. St-Onge MP, Farnworth ER, Savard T, Chabot D, Mafu A, Jones PJ.

This has Farnworth as co-author, and it’s in a quackademic journal, so might be expected, from context, to be positive.

Nope.

RESULTS:

Kefir had no effect on total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol or triglyceride concentrations nor on cholesterol fractional synthesis rates after 4 wk of supplementation. No significant change on plasma fatty acid levels was observed with diet. However, both kefir and milk increased (p < 0.05) fecal isobutyric, isovaleric and propionic acids as well as the total amount of fecal short chain fatty acids. Kefir supplementation resulted in increased fecal bacterial content in the majority of the subjects.

CONCLUSIONS:

Since kefir consumption did not result in lowered plasma lipid concentrations, the results of this study do not support consumption of kefir as a cholesterol-lowering agent. [emphasis added]

Cherry picking secondary outcome measures and ignoring the disconfirmation of primary measures is scientific misconduct. Just as well McTaggart is not a scientist and WDDTY is not a science journal. You have to hand it to WDDTY, though – to cite a source in order to support a statement that is flatly contradicted by the results and conclusions of that source, takes balls.

But then, WDDTY is nothing if not a load of balls.

 

100 ways to live to 100: Your best supplements

Part of a series on WDDTY’s “free” advertorial report “100 ways to live to 100

Your best supplements

Supplements are the “gateway drug” of the SCAM industry. They skirt the boundaries of legitimacy, alluding to incredible claims that are never explicitly made in the adverts – relying instead on extraordinary testimonials and sciencey-sounding bullshit in alternative magazines like WDDTY. Most of the WDDTY editorial panel appear to profit from selling supplements, and this is also a profitable sideline for homeopaths, chiropractors and other quacks.

Unless you live on a farm, grow all your own organic vegetables and have access to free-range meat, it’s almost certain you have vitamin deficiencies even on the best of diets. Ideally, get yourself tested by a knowledgeable nutritionist to determine which nutrients you need or aren’t getting from your food, and customize your supplement programme accordingly.

This is a blatant sales pitch. There is no good evidence that organic produce is significantly more nutritious than equivalent intensively farmed produce, there is a robust consensus that most people with a healthy balanced diet do not need supplements, and SCAM propagandists are in total denial regarding the rather obvious fact that routine supplementation is medication by any definition, and many of the largest supplement manufacturers are also pharmaceutical companies.

Whatever your political slant, you’ll find an ideologically consonant source telling you that supplements are a waste of money. Daily Mirror, Guardian, Telegraph,  Huffington Post, even the Daily Mail. The claim that the human body has evolved such that even the highly nutritious and enriched modern diet is routinely deficient in large numbers of essential nutrients is implausible, and the promotion of this idea is evidence of the propaganda machine that underpins the immensely profitable supplement industry.

And if your diet is deficient in essential nutrients, wouldn’t the prudent thing be to fix your diet?

The very last person you should consult is a “nutritionist”. Has the public learned nothing from Gillian McKeithW, the noted celebrity copromnancer and holder, like Ben GoldacreW’s cat, of a worthless fake “doctorate” form a worthless fake “health college”? Nutritionists are unregulated, may be untrained or (worse) trained in batshit crazy doctrines with no basis in reality, and their main source of income may well be selling the very supplements they recommend.

21 Choose a good quality multivitamin/mineral supplement

Choose a supplement from a reputable brand. If you can’t find one to your liking, take the nutrients individually.

What constitutes a reputable brand? NBTY, formerly Nature’s Bounty, is a $3bn corporate conglomerate; it owns Holland & Barrett and is owned in turn by the Carlyle GroupW. Centrum is owned by Pfizer. Seven Seas is owned by Merck.

22 Make sure you’re getting enough vitamin D

About a third of the general population is vitamin D-deficient. The vitamin offers natural protection against most cancers and heart disease, and can also boost immunity and vascular function. People who regularly supplement with vitamin D increase their longevity by 7 per cent. The body naturally produces it when exposed to sunlight—just 5 to 15 minutes of sunshine a day between 10am and 3pm, without sunscreen, is about enough to do the job.20 Otherwise, supplement with 600–1,000 IU vitamin D/day (400–1,000 IU/ day for those aged 18 and under).

Reference 20: Am J Clin Nutr, 2004; 80: 1678S–88S  Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Holick MF.

Vitamin D is the new vitamin C. The same inflated claims, the same mega dosage recommendations from the same industry lobby groups (e.g. the “Vitamin D council”).

The evidence that adequate vitamin D is important, is pretty solid. The evidence that most people are deficient, not so much. For example, it has been found that the apparent deficiency of vitamin D in African-Americans is an artifact of an evolutionary adaptation; the amount of bioavailable vitamin D is much higher than blood tests suggested.

It is likely that modest supplementation would benefit older people, especially postmenopausal women, though there are potential disbenefits and  some of the claims are shown to be false.

More research is needed. The supplement industry instead spends more money on marketing.

23 Make antioxidants the mainstay of your supplement programme

To minimize damage from free radicals, the toxic byproducts of your body’s metabolism, take adequate daily levels of vitamin A (up to 25,000 IU as beta-carotene or 10,000 IU as retinol), 1–3 g of vitamin E (tocotrienols, up to 600 IU), zinc (10–50 mg), selenium (200 mcg) and vitamin C (1–3 g). And take a good B-complex supplement containing at least 50 mg of thiamine and riboflavin, and 50 mcg of B12.

It’s astonishing that the human race has evolved a metabolism that s incapable of surviving without industrially refined supplements, especially since the availability of these supplements only goes back two or three generations.

Before necking bottles of beta-CaroteneW, it’s as well to be aware that it may increase the risk of prostate cancer, intracerebral hemorrhage, and cardiovascular and total mortality in people who smoke cigarettes or have a history of high-level exposure to asbestos (source).

Once again, a normal healthy balanced diet should contain all the nutrients you need unless you are assessed as deficient by a competent medical professional (i.e. not a nutritionist).

24 Don’t forget magnesium (200–400 g/day) and chromium (100 mcg/day)

According to a large-scale study by the renowned British lab testing service Biolab (see #15), people become deficient in both minerals as they age, and both are necessary for heart health. Magnesium is also essential for bone health and more absorbable than calcium supplements.

Biolab is mainly “renowned” as a lab which offers dodgy diagnostics alongside proper ones and refers people to half the editorial board of WDDTY for treatment of the non-existent conditions they thus diagnose.

NHS Choices seems to think that magnesium and chromium are both widely present in the diet, with no supplementation necessary. The difference may be explained by the fact that NHS Choices is not selling diagnostic tests to allow its referred physicians to profit by selling you the supplement. But that would be conspiracist thinking, and we should probably leave that to WDDTY.

25 Take good-guy bacteria

Invest in a quality probiotic, which includes lactobacilli, bifidobacteria, Saccharomyces boulardii and non-disease causing strains of Escherichia coli and streptococci.

I think you’ll find it’s a bit more complicated than that.

Probiotics have been tested on a long list of diseases and conditions, and it appears that a scientific consensus is approaching for the use of certain probiotics for lactose intolerance and rotavirus diarrhea. Claims related to these benefits may be the first to be accepted in many jurisdictions. Before other claims are approved, manufacturers will have to invest considerable time and money to obtain data to show the efficacy and safety of their probiotic product. The data and documentation required to obtain a label health claim will be different in different jurisdictions because of differences in legislation. These discrepancies will add to the challenges faced by probiotics producers and consumers. – J. Nutr. June 2008 vol. 138 no. 6 1250S-1254S The Evidence to Support Health Claims for Probiotics

That’s probably why the Mayo Clinic says that “You don’t necessarily need probiotics — a type of “good” bacteria — to be healthy”.

The probiotic industry is also huge. Major manufacturers are Danone (a multi-billion-Euro French multinational) and the Japanese Yakult corporation. Yakult submitted a request for marketing authorisation, the result of which was:

The Panel concludes that a cause and effect relationship has not been established between the consumption of Lactobacillus casei strain Shirota and maintenance of the upper respiratory tract defence against pathogens by maintaining immune defences.

Still, at least Yakult is actually paying for some research, albeit that it has precisely the same sources of bias as any other industry funded research, and still doesn’t support the claims they want to make.

Colds and cough

Colds and cough
The name “what doctors don’t tell you” implies that everything in WDDTY is a deep, dark secret known to doctors but not passed on to patients. In practice, many stories combine two strands: things doctors definitely do tell you (usually taken form the medical journals) combined with disinformation and propaganda for the SCAM industry. It is the latter that doctors don’t tell you, usually because it’s agenda-driven nonsense.

Doctors have been telling you for a long time that over the counter cough remedies are pretty much useless. Patients routinely demand antibiotics for colds and other viral illnesses, doctors have been recommending against this for a long time (it’s more of a problem in the US where some antibiotics are available OTC and where “big pharma” advertises direct to patients).

The study of cold remedies is worthwhile. It is one of the few areas where pharmaceutical companies and SCAM play the same game, because for the most part it involves over the counter remedies sold direct to patients, not prescription medicines.

It’s Christmas, the season for classic movies. Perhaps McTaggart has decided to simply round up the usual suspects. Medicines are evil, supplements are good, if all research is filtered with that assumption then the result confirms the assumption. Selection bias at its finest.

WDDTY promotes the interests of the SCAM industry, whether intentionally or not. Wikipedia has no such agenda: its article on alternative treatments used for the common coldW is largely written by proponents, but even so it is still significantly less effusive than WDDTY. People are paying WDDTY for impartial advice, and what they get is less impartial than the free advice on numerous websites including Wikipedia.

We have no problem in discouraging excessive medication or discussing issues with medical treatments. We do have a problem with using this as an alternative to engage in precisely the same chicanery and evidential sleight-of-hand in order to promote an industry that is at least as bad as “big pharma”, which uses propagandists like WDDTY in lieu of proper research, and which in some cases turns out actually to be “big pharma”.

If this is all a bit TL;DR, do page to the end for that classic caught-with-the-trousers-down moment.

Colds and cough

Most cold and cough medicines are useless and may do more harm than good, particularly in kids. Joanna Evans reveals the safer alternatives that can combat colds naturally.

The bait and switch is stated right up front. It’s well known that a cold will last about a week, but with Miracle Remedy X it will be gone in only seven days. This applies to all cold remedies, almost without exception. The most widely studied “natural” cold remedy, vitamin C, has been reported time and time again not to make any difference at all.

In fact doctors give accurate, evidence-based and nuanced information about supplements and medicines for colds and other minor ailments, just as they do for serious illnesses. The SCAM industry is somewhat less scrupulous.

You might want to think twice before you reach for that cold or cough medicine this winter. Few of them actually work, and according to official drugs regulators on both sides of the Atlantic, many pose serious dangers to children—possibly even putting their lives at risk.

Depending on how you read the results, of course. But once again: this is not a secret. Doctors are completely open about the fact that patent remedies mainly don’t work, and WDDTY’s anti-medicine agenda is once again undermining public trust in the people who are the best informed and most reliable sources of health information.

A recent review by American researchers at the St Joseph Family Medicine Residency in Mishawaka, Indiana, revealed that nearly all the conventional cold treatments they looked at—including antibiotics, inhaled corticosteroids and over-the-counter (OTC) antihistamines, decongestants and antitussives (cough medicines)—simply don’t work, either for adults or children (see charts, page 51).

Antibiotics? for colds? Only an idiot would take an antibiotic as primary therapy for a viral illness. The regulators say it, the medical schools say it, the NHS says itpharmacists say it, the press say it. And actually the same applies for cough medicines and most other OTC cold “remedies”. So this already looks like a classic straw man.

More worrying, the researchers flagged up evidence showing just how dangerous these medicines can be for children—especially the very young. According to data from the American Association of Poison Control Centers, cold and cough medicines are among the top 20 substances leading to death in children under five, the researchers said.1

Reference 1a: Am Fam Physician. 2012 Jul 15;86(2):153-9. Treatment of the common cold in children and adults. Fashner J, Ericson K, Werner S.

Reference 1b: Clin Toxicol (Phila). 2010 Dec;48(10):979-1178. 2009 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 27th Annual Report. Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Giffin SL.

The WDDTY claim is mendacious. To quote reference 2: “The top 5 most common exposures in children age 5 or less were cosmetics/personal care products (13.0%), analgesics (9.7%), household cleaning substances (9.3%), foreign bodies/toys/miscellaneous (7.0%), and topical preparations (6.8%).”

This makes the context entirely clear. NPDS data is used to track poisoning events, and to search for indications for poisoning. It includes accidental and intentional cases, there is no indication that the outcomes result from use of medicines within the instructions. Accidental and intentional overdoses and children swallowing unattended adult medications will account for the majority of these cases.

Even drugs regulators in both the US and UK are urging parents to steer clear of these drugs for their young children. In 2008, the US Food and Drug Administration (FDA) issued a public-health advisory recommending that OTC cold and cough medicines should not be used to treat children less than two years of age “because serious and potentially life-threatening side-effects can occur from such use”.

Mendacious again. The advice is to minimise all medication, whether branded “natural” or not. Colds go away on their own. The advice, for at least two decades, has been fluids, rest and possibly low-dose paediatric analgesics for symptomatic relief of headache where this is causing distress. WDDTY seem to want you to believe that Calpol is as much of a problem as an accidental overdose of adult painkillers left unattended. Why would they fail to point out the obvious difference? Why would they fail to contextualise the data correctly?

Unless of course they are trying to undermine faith in medicine in order to promote their own agenda and the financial interests of their advertisers.

Reports suggest that the drugs can cause a wide variety of adverse effects, the FDA said, including convulsions, rapid heart rates, reduced consciousness and even death.2

Reference 2a: FDA Releases Recommendations Regarding Use of Over-the-Counter Cough and Cold Products

Reference 2b:  An Important FDA Reminder for Parents: Do Not Give Infants Cough and Cold Products Designed for Older Children

Taken together, you see the obvious. These events are due to parents giving children remedies designed for older children. That’s a vital piece of information. Many OTC cold remedies contain paracetamol, an effective and well tolerated analgesic when used correctly, but with significant toxicity in overdose. And the dose is linked to body mass and age.

The message in the FDA statements is abundantly clear: read the label, follow it, do not give infants products for adults or older children; this is fully consistent with the NPDS source.

But WDDTY is ignoring this obvious fact and pretending that the products themselves are inherently dangerous.

These reports of harm arose when children received too much medication, according to the FDA, as in cases of accidental ingestion, unintentional overdose, or medication-dosing error. 

Indeed. Or giving infants medicines designed for adults or older children.

But other evidence suggests that serious side-effects can occur even with appropriate dosages.3

Reference 3: Clin Pediatr Emerg Med, 2012; 13: 292–9 Cold and Cough Medications for Children: Dangerous and Over the Counter! Elizabeth Yust, Ann Slattery

WDDTY staple: can occur does not mean will occur or even is likely to occur.

Let’s compare WDDTY’s alarmist message with the abstract of the paper itself:

Young children have cold symptoms multiple times per year, which are usually part of a viral upper respiratory illness. Fever is commonly associated with these viral upper respiratory infections and is one of the most frequent chief complaints for children presenting to an emergency department. Cold and cough medications (CCMs) are widely marketed and used for the relief of cold symptoms. Studies have not found the ingredients in CCM to be beneficial for symptom relief. Both the Food and Drug Administration and American Academy of Pediatrics have recommended against the use of CCM in young children younger than 2 years, citing a lack of efficacy and potential for harmful side effects. Clinical toxicity and death have been reported both with therapeutic use, misuse, and overdose. In addition to unintentional harm, CCM can be misused and/or abused. The purpose of this article is to review the classes of medications found in over-the-counter CCM, the epidemiology of their use, the pharmacology and clinical toxicity of specific medications, dextromethorphan abuse, and the management of children presenting with overdose or adverse effects.

So, far from being something “doctors don’t tell you” ,this is doctors actually telling you something, and WDDTY exploiting it not only in order to pretend that doctors are somehow covering up a problme, but also in order to imply that the problem is much greater than it actually is.

And of course in order to promote natural woo as an alternative. We mustn’t forget the marketing payload in every WDDTY story.

Similar concerns over the use of OTC cold and cough medicines have been raised in the UK. Shortly after the FDA’s advisory, the UK government’s Medicines and Healthcare Products Regulatory Agency (MHRA) warned that OTC cold and cough medicines shouldn’t be used in children under six. “There is no evidence that they work and can cause side effects, such as allergic reactions, effects on sleep or hallucinations,” the MHRA said.4

Reference 4: Children’s over-the-counter cough and cold medicines: New advice

So what is it that doctors aren’t telling you, then? Oh wait, I remember: doctors aren’t promoting your advertisers’ products instead. And that “new advice” was last updated in November 2010. This is not news to anyone who has the remotest interest in evidence-based practice.

Considering that many of the standard cold medicines don’t work for adults either,1—and could have sedative effects that make it dangerous to drive or work—you may be better off avoiding cold and cough medicines altogether and looking to one of the many safer, effective alternatives.

If you want to ease symptoms, get well quicker and even slash your chances of getting a cold in the first place, check out our handy guide to the natural remedies that work for both adults and children.

Just one problem: the evidence supporting your “alternatives” is no better than the evidence supporting OTC remedies.

Astroturfing: Why the information in wddty can be (is!) suspect

This story was inspired by Astroturfing: Why the information on patient group sites can be suspect, wddty, August 2006, and the editors’ apparent inability to join the dots.

There are plenty of tactics that the SCAM industry employ in order to increase sales.  Getting to quacks is easy enough:  ‘educational’ seminars, bogus “research”, payment for “research projects” by putting patients onto untried and often ineffective quack remedies, and funding whole careers are just a few of the gambits they use.

But how to get to the patient directly? Short of straight advertising, one of the best techniques is known as ‘astroturfing’. This involves exploiting the near-religious fervour of woo-believers that, in turn, start promoting the pro-SCAM message to unwitting members who want unbiased information on their condition.

Herbalife (HLF) has just been caught out ‘astroturfing’ via Senator Tom HarkinW, the driving force behind the Dietary Supplement Health And Education Act of 1994W. This extended the already lax regulation of supplements in the US by actively preventing the FDA from exerting any authority over the industry, as long as no actual medicinal claims are made. Harkin’s retirement has been described within the SCAM industry in terms similar to a successful sports team losing a long-time great manager.

Herbalife is promoted by multi-level marketingW, and indeed is often considered a pyramid schemeW; like most of SCAM it makes no attempt to stop people linking to the various credulous sites (including WDDTY) that make medicinal claims for its products, leaving it free to advertise on an availability-only basis and thus completely evade any requirement to provide evidence of efficacy or safety.

OxyElite Pro was a “sports supplement” found to cause acute liver toxicity. The FDA was able to regulate swiftly only because it contained aegeline, which was not in use prior to 1994 and therefore counted as “new”. AristolchiaW was sold by supplement companies as an herbal supplement without indications and promoted by miracle diet scammers as a diet product; the result was a serious outbreak of kidney disease and cancers, with several women left dead.

Sadly WDDTY, no doubt due to reasons of space, chose not to cover either of these scandals though it has, having found a way of spinning it as “evil big pharma”, finally acknowledged that contamination of Chinese herbs is rife.

The Advertising Standards Authority, which oversees advertising in the UK, has ruled in dozens of cases against quacks making unsupportable claims for supplements, many of them in WDDTY itself. The quacks are very foolish: they have no need to do this as long as WDDTY and its ilk happily make the bogus claims on their behalf under the guise of “education”. For them, WDDTY is the natural alternative to astroturf. They are certainly smoking something….