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Monday, March 27, 2006

Uh Oh Wall Street Journal

WSJ Wrong on Vitamins

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The Case Against Vitamins, a March 20th article in the Wall Street Journal, suffers from tunnel vision. There is an understandable tendency for the media to embrace controversial stories, contributing to an environment where one single study is touted as negating every other study that has ever been done on a nutrient. The "several studies" cited in this report have been seriously criticized by experts, without these rebuttals generating any real media attention to counter the negative initial reports and set the record straight.

It is understandable why such provocative reports get wide coverage, but not why the subsequent, legitimate criticism of the studies doesn't. Our mass media has a collective amnesia. This leads to public confusion about supplements, fueling a growing public mistrust of the reliability of media reports on all nutrition topics. The public is given a false sense of what a study means, with dietary supplements frequently singled out as being harmful or useless (or both!), even when these accusations are not supported by good data.

But sometimes that one study is poorly designed and/or gets inaccurately represented in the press. Low fat diets, anyone? Vitamin E?

No wonder people are so confused about nutrition and diet, when even scientists can't figure out how to study and report on these topics accurately! The sensational headlines and stories promoting controversial - and often contradictory - science reports have dazed the public with far more impact than the rare correction or follow-up report.

This WSJ article singled out Beta Carotene as promoting cancer. That controversial study was recently revisited, with researchers looking instead at total antioxidant intake. They discovered that low antioxidant intake was the real culprit in that original cancer study, not beta carotene supplementation. Why hasn't this new information replaced the old conclusion that mistakenly blamed beta carotene?

Your article also mentioned that antioxidants may "promote some cancer and interfere with treatments". That published 'review' referenced only one study that directly looked at an antioxidant used with cancer treatment that found no difference in outcome, a far cry from the well-publicized conclusion that antioxidants should be avoided. Yet my rebuttal, published by the same peer-reviewed journal (CA) of the American Cancer Society and available online, documents in detail dozens of cases where specific vitamins and antioxidants enhanced cancer therapies. Forty percent of cancer patients die of malnutrition, a figure that can be increased if poorly substantiated science and sensationalist reporting stops people from taking essential and beneficial nutrients that are proven to save lives.

Why do media reports ignore cautions given in studies that their results are not applicable to other populations? Why is the normal process of science - a testing of theories and criticism of studies that corrects and refines the original results over time - being almost completely ignored in rushing to publicize these unrepresentative studies that show vitamins in a bad light? Why is evidence that the researchers and the WSJ admit is "inconclusive" used as an argument against Vitamin E safety? What part of "inconclusive" do you fail to understand?

The Vitamin E controversy should have been cleared up after the American Journal of Clinical Nutrition did a far more thorough review than the 19 studies used in the Annals of Internal Medicine review article, which itself has generated dozens of critical letters from scientists all over the world (my own comments are posted there, as well). The AJCN report, titled "Vitamins E and C are safe across a broad range of intakes", is far more authoritative than the Annals review and specifically considered their results. There is continuing research showing that various forms of Vitamin E may be useful for people suffering from Parkinson's, macular degeneration of the eyes, cataracts, cancer, reducing mercury toxicity, etc. The Food and Nutrition Board of the Institute of Medicine has set an upper tolerable intake level (UL) for vitamin E at 1,000 mg (1,500 IU) for any form of supplementary alpha-tocopherol per day.

The recent reports claiming that 'B-Vitamins don't lower risk for heart attacks' missed the point entirely. They do lower levels of homocysteine, an inflammatory substance, as well as reducing the number of non-fatal strokes. In reality, homocysteine has now been challenged as a theoretical cause of heart disease, but the B-Vitamins performed exactly as predicted. How does that translate into any kind of failure?

This type of reporting is really a game of 'blaming the vitamins'. It has nothing to do with the real science or the place of one study in the big picture. Rarely does a single study trump all previous science, but bad science generates big headlines by generating controversy. Review studies often create problems by lumping too many variables together. Population studies do not show cause-and-effect and are unreliable. Large doses of nutrients, taken separately, can be predicted to fail in almost any study because nutrients are inherently interactive. The problem is that you are playing this game with real human lives, and scaring people away from taking healthy nutrients can cause more pain and deaths than the theoretical "risks" shown in unsubstantiated studies.

It's time for more balanced reporting on vitamins and other nutrients. The Lewin Group has published studies proving that use of supplements can save health care costs by billions of dollars. The FDA has approved health claims for vitamins and minerals. The risk of getting ill from a vitamin is a tiny fraction of the risk from eating a meal, and the risk from taking a pharmaceutical drug is far greater still. It's time for the media to consider why they constantly attack nutrients, and figure out how to report these studies in a context that is far more accurate.

Neil E. Levin
Certified Clinical Nutritionist
Nutrition Education Manager, NOW Foods
Bloomingdale, IL


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