Saturday, September 01, 2007

Book review: Natural Causes

This book scared the bejebus out of me. Natural Causes is an exposé of the politics and practices of the herbal supplement and vitamin industry. That doesn't sound so dramatic, but what author Dan Hurley is really doing is revealing the fundamental lack of sound science that lies behind the use of any "natural" supplements and vitamins. Every chapter begins with a true and tragic story of the grisly results of using the products Hurley covers, even those that are advertised as supposedly benign. Hurley goes on to detail the utter lack of proven effectiveness of any of these items, leaving little doubt that there is absolutely no reason to be taking any of this stuff. (He does allow for the possible positive use of folic acid--with a caveat--for women trying to become pregnant, and notes that Americans, at least, are actually deficient in vitamin D, but almost nothing else comes through his analysis unscathed.)
The most surprising discussion, of course, is that of vitamin supplements, and while he does not have a vignette of someone being horribly disfigured or permanently messed up from taking too many vitamins, he quotes from a whole bunch of studies revealing that vitamins don't do much good at all. (I've included some of these as an "appendix" below.)
How can this whole industry escape the notice of the FDA? Hurley explains that successful lobbying by the leaders of the supplement industry, as well as the support of our old friendly psycho arch-Republican Orrin Hatch (whose native Utah is the headquarters for the vast majority of the supplement companies)--in addition to a PR campaign designed to scare the populace (gee, where have we heard that before?), made mincemeat of any opposition to a bill gutting the FDA's oversight of the supplement industry in the mid-1990s. Supplements, it seems, are legally considered to be neither foods nor drugs (even though in most cases they are derived from the exact same plants as the prescription drugs they are designed to emulate/replace), and therefore are now empowered by definition to fall between the jurisdictional cracks in our regulatory net. Even in the most extreme cases (like ephedra), the FDA is so hamstrung by this legislatory restriction that even the multiple deaths directly caused by the substance weren't enough to allow them to instantly pull ephedra off the shelves without a legal tussle.
Natural Causes is a scary, necessary analysis that deserves a wide audience.

Appendix:
" . . . guidelines, jointly prepared by the Department of Health and Human Services and the Department of Agriculture . . . recommend B12 for adults over fifty and folic acid for women of childbearing age who may become pregnant[;] nowhere do they recommend a multivitamin for anyone." (pg. 166)
Although "a 2004 study found tentative signs of a slightly increased risk of death, and of breast cancer, in women years after they took it during pregnancy." Folic acid can also worsen a B12 deficiency, leading to anemia and even brain damage.

On antioxidants:
From New England Journal of Medicine 4/14/94: A study "[c]arried out by the National Cancer Institute in partnership with Finland's National Public Health Institute . . . involved 29,000 Finnish men, all long-term smokers over the age of fifty. Smokers had been picked specifically because of their increased risk of getting cancer and heart disease sooner. They were each given either vitamin E, beta carotene, a pill that contained both, or one that contained neither. . . . [T]hose taking the vitamins saw no benefit over those getting the placebo. Instead, the men taking beta carotene were actually slightly more likely to die of lung cancer or heart disease."
A later study similar to this one (funded by the NCI) involving vitamin A and beta carotene showed that "the death rate from lung cancer was actually 28 percent higher among people taking the vitamins than those taking the placebo, and the death rate from heart disease was 17 percent higher." (pg. 170)

Lancet reviewed 14 studies on antioxidants, reporting in 10/04 that there was no "evidence that antioxidant supplements can prevent gastrointestinal cancers; on the contrary, they seem to increase overall mortality." (pg. 171)

On colds:
From JAMA 8/02: "Those given a multivitamin did no better on any measure of colds than those given a placebo, whether on the number of colds per year, their severity or duration, the number of symptoms, or the need for bed rest or medication--and those given vitamin E actually did worse." pg. 172)

On calcium:
NEJM 2/16/06: " . . .calcium with vitamin D supplementation is not an effective means of preventing fractures in this population [postmenopausal women]." (pg. 174)

On children and multivitamins:
From Pediatrics 7/04: National Maternal-Infant Health Survey of 8285 preschool children. " . . . all those who had received vitamin supplementation by the age of three had a 63 percent increased risk of food allergies if they had been breast-fed, or a 39 percent increase if they had been exclusively formula-fed." (pg. 175)

On Vitamin A:
JAMA 1/02: Nurses Health Study on more than 72,337 postmenopausal women. "Those who took at least 2000 micrograms of retinol (a primary component of vitamin A), whether through food or supplements, were 89 percent more likely to have suffered a hip fracture than those who took less than 500 micrograms." The FDA Recommended Value is 1500 micrograms, and "most multivitamins contain at least that much." (pp. 175-6)

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3 Comments:

Anonymous tfj said...

This may all be true, and I am aware of exceptions to all rules. However, as a 72 year old former heavy drinker (20 years, one to two pints per day); heavy smoker (27 years, two to three packs per day); heavy user of many other unhealthy substances and gluttonous partaker of every unhealthy food known, I am convinced that my intake of 800IU of vitamin E on a daily basis has been very instrumental in keeping me alive and helping me to survive both heart disease and cancer.
On the other hand, maybe I'm just lucky.

9:45 PM  
Anonymous Anonymous said...

The USA has the healthiest pee in the world. By that I mean that ANY excess of any vitamin, besides A,D,E & K, is excreted. Those four can lead to some toxicity if one ingests more than the maximum daily requirement. I read recently that multivits & minerals really don't help much. And how can anyone in sunny CA have less than the vit. D than they need???
I remember the attack on Herballife - and how did that end up? I see it's still in business! You can try to shut down all the big companies but what about all those small companies that seem to always fly under the radar? Especially when the FDA has no guts & no teeth in their rules! Frustrating!

3:10 PM  
Blogger bryduck said...

The author covers Herbalife and the lawsuit; as far as I can recall, it ended the way all these lawsuits have ended--in favor of the defendant! Although most likely this took the form of undisclosed settlements, no judgment has ever gone against the herbal companies since the legislation detailed in the book was passed. As far as the FDA lacking guts, I don't think that's the case--they've been effectively neutered by Congressional action in these matters. I do agree that it is frustrating, however . . .

4:37 PM  

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