383 Blocking the Truth [22 Aug 2016]

I’m normally skeptical of claims of media bias by people who disagree with a published news item. Recently I came across a book that opened my eyes on the extent of corporate and government influence on mainstream news in the USA (and I’m sure in Canada too).

Sharyl Attkisson is a 30 year veteran investigative journalist (and with 5 Emmys, must be a good one!). She was the reporter who in 2009 exposed the CDC’s cover-up in the H1N1 Swine ‘Flu “epidemic”. She has exposed many other scandals and controversies under both Republican and Democratic US governments.

Her 2014 book “Stonewalled: My Fight for Truth Against the Forces of Obstruction, Intimidation, and Harassment in Obama’s Washington” tells the story of her growing frustration in getting her stories aired on CBS TV. She reports her own experiences and puts it in perspective of the larger picture of “the decline of investigative journalism and unbiased truth telling in America today”. CBS upper management began blocking publication of certain stories. Her telephone was tapped and computers infected with a spyware owned by the CIA and FBI. In frustration she finally left CBS after 20 years to work independently. The book “Stonewalled” is one result.

How does this relate to health? It’s not just government that influences media – corporate sponsors also have undue influence with their advertising dollars. Pharmaceuticals and biotech industries particularly have a long history of quashing unfavorable stories. Here are some of the issues that, according to Attkisson, mainstream media will no longer touch:
• Vaccination safety – this one is particularly taboo
• GMO & glyphosate safety – look what they did to Dr. Oz last year
• Side effects of pharmaceuticals – especially popular ones like statins

So don’t assume because you see or hear nothing on these issues on TV or in the daily newspaper that they are unquestionably safe. Rather it’s because no one is allowed to question them. We can no longer depend on mainstream media to provide unbiased reporting.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

252 Some Positive Nutrient Studies [27 January 2014]

Over the last few weeks I have explained why flawed nutrient intake studies can show little or no benefit. Rather than belabor the point further (and I could, discussing dosage, nutrient form, etc) this week I am listing some of the hundreds of studies that have shown benefit from nutrient supplementation. This is just a small sample:

• A UCLA study in 1990s, with 11,000 men over 10 years found that 800 mg daily vitamin C reduced cardiovascular mortality by 42%, adding an average 6 years to their life.
• The Physician’s Health Study II found that taking a multivitamin was associated with reduced risk of death, over 11 years, of 12% from cancer and 39% from heart attacks.
• Supplementation in Vitamins and Mineral Antioxidants Study found a 31% reduction in total cancer incidence in men taking a multivitamin.
• A 2013 study of 77,446 adults found an inverse relationship between dietary selenium and the risk of pancreatic cancer.
• A 2007 study of 81,184 people found low B6 intake associated with an increased risk of colorectal cancer.
• A 2012 study on 23,943 people found that taking an antioxidant multivitamin reduced the risk of death from cancer by 48% and from any cause by 42%.
• A 2009 German study found that vitamin D3 supplementation reduced the risk of falls by 27% (more on this next week)

Note that some of these are “observational studies” that discover a relationship but do not necessarily show cause and effect. But when random controlled prospective studies fail to show the expected results, the researchers should first look for possible causes before concluding that supplementation is useless.

Sources:
“Are Multiple Vitamins and Minerals Really Worthless?” unpublished article by Dr. Zoltan P. Rona
Call to clinicians: Report vitamin D data by John Cannell, MD 20 Jan 2014

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

251 Nutrient Co-Factors [20 January 2014]

Last week I explained how the unique features of the dose-response relationship for nutrients can skew the results of nutrient intake studies towards showing no benefit. Another reason why nutrient studies often find little or no benefit is that adequate levels of cofactors are rarely ensured. Unlike drugs, nutrients work better together, and often don’t work at all without certain others. To accurately test the effect of a single nutrient on a particular process (eg bone-building), all the other nutrients required for that process must be adequately available. For example, to test the effect of calcium supplementation, all the other nutrients required for bone building must be available in adequate amounts: vitamin D, vitamin K2, magnesium, protein, and certain B vitamins. Without ensuring adequate levels of these co-factors, the study results will be meaningless and misleading.

Most nutrient studies are designed following the drug model which attempts to eliminate the effect of all other variables. But instead of eliminating the effect of cofactors by ensuring adequate levels, they are too often simply ignored. The results may be accurate for what is actually being tested – e.g. that calcium supplementation alone does not significantly increase bone formation, but to conclude that calcium is worthless would be erroneous. Instead, further studies are required to determine the optimum levels of each of the other co-factors.

The failure to consider cofactors, along with the location on the dose-response curve discussed last week, is likely responsible for the “equivocal and sometimes contradictory” vitamin D trials referred to in the Editorial “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements” (J Annals Int. Med, 17 Dec 2013). In one sense I agree with the authors of this editorial when they state “…further large prevention trials [of vitamins] are no longer justified.” Conducting more poorly-designed nutrient trials that are incapable of testing what they purport to be testing would not only be a waste of time and money but their erroneous conclusions may dissuade many from actions that might improve their health.

Source: Robert Heaney – Some Rules for Studies Evaluating Nutrient Effects

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

250 The Nutrient Dose-Response Curve [13 January 2013]

Last week I discussed a medical journal editorial which claimed that supplements don’t work and are just a waste of money. I ended by introducing the nutrient paradox – how it can be that nutrients, by definition essential for life, frequently show little benefit in supplement studies. This week I will examine some of the reasons for this paradox.

Robert P. Heaney, MD, a world-renowned endocrinologist specializing in bone, calcium & vitamin D physiology, published an article in June 2013 titled “Some Rules for Studies Evaluating Nutrient Effects” which explores some reasons for this paradox.

Heaney first looks at the dose-response relationship for nutrients which shows a sigmoid (S-shaped) curve when graphed. At low intakes there is no observable effect – there just isn’t enough to do the job. Then at higher intakes there is a strong response to increased dose. Finally at some level the curve flattens again and there is no additional benefit from taking more. Unlike drugs, any nutrient being studied will already occur at some level in the participants. The key is to know where on the curve the study population lies. In the case of the elderly physicians study mentioned last week, it’s likely that they were well-nourished with few deficiencies, so would be less likely to benefit from a multivitamin. This conclusion however cannot be transferred to other populations. The Women’s Health Initiative trial which found little to no benefit from calcium supplementation fell into a similar trap because the participants were already at or above the recommended level of calcium intake. Heaney asks, with apparent frustration, why this flawed study is still being quoted.

Heaney also explains that the middle section of the curve where increasing dose increases benefits is generally much narrower for nutrients than for drugs, meaning there is a smaller range of intake that will show a particular effect. Nutrient studies will not detect any benefit outside of this narrow range which is approximately 1 order of magnitude (10x difference from the lowest to highest) for nutrients, compared to 2 or even 3 orders of magnitude (100x to 1000x) for drugs.

And because the curve is not linear (a straight line), pooling data from studies with different doses, different participant base levels, and/or different durations (length of study) will produce confusing, misleading results. The first study mentioned last week was one of these.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

249 Multivitamins – a Waste of Money? [6 Jan 2014]

Did you see any of the news headlines a few weeks ago like “Multivitamins a waste of money” or “Vitamin, mineral supplements offer no benefits”? These were newspaper reports of an editorial in the December 17 Annals of Internal Medicine which was commenting on three studies published in the same issue. The first was a review of 27 trials of single or paired vitamins which found no clear evidence of benefits on all-cause mortality, cardiovascular disease or cancer. The second was a large 12 year controlled study of elderly physicians which found no difference in cognitive decline between multivitamins and placebo. The third found no significant difference in recurring cardiovascular events (heart attack) with the use of a “high dose 28-component multivitamin”.

Based on these three studies, with vague reference to previous research with similar results, the editors concluded that effects – either beneficial or harmful – of multivitamins are too small to be detected with such small trials and, while conceding that there may be small benefits or harms in a small subgroup of the population, conclude that the “case is closed” and “…vitamins should not be used for chronic disease prevention.” The editors go beyond that, warning about certain harmful vitamins and even describing vitamin D studies (which have shown clear strong benefits in many different health areas) as equivocal and contradictory. What surprised me most though was their call to halt research: “…large prevention trials are no longer justified…” which scientists almost never do. Journalists (and their editors) with little science and no nutritional expertise then take these opinions (which is what an editorial really is) and run with them, concocting the misleading headlines, with accompanying articles, mentioned above.

This editorial raises so many important issues that it will require several columns for an adequate response. Next week I will discuss the nutrient paradox – how it can be that nutrients, by definition essential for life, frequently show little benefit in supplement studies. In later columns we’ll examine the three above-mentioned studies in more detail. Stay tuned! By the way I am still taking my vitamins.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

228 Omega-3 & Prostate Cancer [5 August 2013]

Men - did you see any of the headlines last week about fish oil causing prostate cancer? If so, I hope you didn’t swear off salmon and throw away your Omega-3 capsules. The evidence the headlines were based on is pretty flimsy.

In an observational study published July 10 in the Journal of the National Cancer Institute, data from the SELECT Selenium and Vitamin E Cancer Prevention Trial were extracted to examine a possible link between omega-3 levels in blood and prostate cancer risk. A positive association was found with DHA, one of the fish oil Omega-3 EFAs and both low-grade and high-grade prostate cancer (44% and 71% increase respectively).

These numbers sound pretty significant, but are they? First of all, correlation does not necessarily mean causation. The lowest risk of prostate cancer in this study happened to correlate with the highest trans fatty acid levels, but no one is even suggesting that TFAs, with well-known harmful effects, prevent cancer.

Blood levels of EFAs depend on your most recent meal, not on long term eating habits, which is not included in the data. So we don’t know how much fish, if any, the men in this study ate or if they took omega-3 supplements.

The total omega-3 levels, as a percent of total blood lipids, in both groups was quite low – 3.66% in the group who got cancer and 3.62% in the group who didn’t, and the difference very slight. Yet Japanese men, who consume 8 times as much omega-3s as Americans, have a much lower prostate cancer rate.

The researchers in this study did not control for age, race or diet and other known risk factors may not have been completely accounted for. Of the men who got cancer, 53% were smokers, 64% regularly consumed alcohol and 80% were overweight or obese.

The overwhelming majority of valid studies – larger and much better designed – show that omega-3s lower cancer risk, including prostate cancer. One study from Harvard School of Public Health which followed 20,000 men for over 22 years found that men who ate fish 5 or more times per week had a 48% lower risk of prostate cancer death than those who ate fish less than once a week. And a 30 year study from Sweden concluded that eliminating fish from your diet could increase your risk of prostate cancer by up to 300%. Now that’s significant!

The only way to explain the study’s conclusions - and the news stories that promoted them – is a desire for sensational headlines and a strong anti-supplement bias. And I don’t think I’m stretching it here. One of the researchers, Alan Kristy, was quoted: “We’ve shown once again that use of nutritional supplements may be harmful.” Baloney! What they have shown is that following nutritional advice from mainstream media may be harmful.

Sources
Dr. Jonny Bowden in Huffington Post
Dr. Michael Murray
Dr Robert Rountree, Chief Medical Officer at Thorne Research, in Dr Nalini blog

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

191 Diet Soda & Cancer [12 November 2012]

An interesting flip-flop on a news item happened last month. A study was published in the Am J Clinical Nutrition on October 24, showing a higher risk of blood cancers with consumption of diet soda (and by implication aspartame). As is customary, copies were released to news media a few days before so their stories would come out on publication date. Then just half an hour before publication, a news release was sent out by the Harvard Brigham and Women’s University asking the media not to run the story because “the data is weak”.

The study was significant for several reasons. It followed 115,000 adults for 22 years looking at the relation between diet soda consumption and blood cancers. The long term is necessary to determine the effects of chronic exposure, and to enable detection of cancers (the longest previous human study on aspartame toxicity was only 19 weeks). It found that men (but not women) who consumed more than 1 diet soda per day had an increased risk of non-Hodgkin lymphoma and multiple myeloma, and that both men and women had an increased risk of leukemia. The gender difference can be explained by men producing more of the enzyme ADH that converts methanol from aspartame to formaldehyde. The risk increases are small but statistically significant, and in the authors’ view warrant further study.

So was the publication of the study premature? Or could there possibly be some industry pressure put on the university to recant? A 2006 New York Times article reported that all of the industry-funded studies on aspartame (to date) found it safe, while 92% of the independent studies found significant problems. The US FDA has had more adverse reports on aspartame than all other food additives combined. Another article on aspartame [The Defense of Diet Soda] listed some of the health problems linked by studies to diet sodas: heart attacks, strokes, cancers, osteoporosis, tooth decay, and nervous system disorders. And while some studies show improved weight loss for diet soda drinkers, there are many others that don’t or show the opposite – that diet sodas cause weight gain. So there are many reasons to avoid diet sodas and really no reason to drink them. The pulling of the news story reminds me of a line by Hamlet’s mother: “the lady doth protest too much, methinks”.

Two other online articles on this subject that I referred to were: "Study: Aspartame linked to blood cancers" by E. Hector Corsi, Digital Journal, 7 Nov 2012, and "Aspartame Associated with Increased Risk of Blood Cancers in Long-Term Human Study" by Dr. Joseph Mercola, 7 Nov 2012.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

188 Vitamin D Window [22 Oct 2012]

The best way to get vitamin D is from the sun. The vitamin D synthesized in our skin in the presence of UVB rays is the sulfate form which is water soluble and therefore more physiologically active. But for most of the year in Saskatchewan unless you use a safe sunlamp or take a holiday in the tropics, supplementation is the only way to keep your D levels up.

The UVB rays necessary for vitamin D synthesis can only penetrate the atmosphere when the sun is at 50° or more above the horizon. I knew that our vitamin D season was short, but when I did the calculations (using a US Navy website) I was shocked. The last day we could make vitamin D was August 21 and the next day will be April 18. On those two days there is about a half hour “window” centered on 1:15 pm (which is the sun-noon for Rosetown’s longitude). For most of June the “window” extends from 11:00 am to 3:30 pm. On sunny days outside these time “windows”, and on cloudy days, you can still get a sunburn and increase your risk of skin cancer from UVA, but you can’t make any vitamin D.

A recent study from New Zealand published in JAMA in October found a small but statistically insignificant reduction in upper respiratory tract infections (colds & “flu”) in healthy adults with supplementation of 100,000iu D3 monthly (equivalent to 3,330 daily). The average vitamin D level of the test population was low but not severely deficient (likely due to sun exposure), which may explain the small difference. For example, two previous studies with children in Mongolia and in Japan who had severe D deficiencies, showed much more significant improvement with D supplementation. Other studies have found that people with lower levels of D had more frequent colds or missed more work due to colds, and that newborns with a D deficiency were more susceptible to bronchitis and pneumonia. In any case there are many other good reasons to keep up your D levels – this is my 23rd column on this important vitamin.

To give credit where due, the New Zealand study appears to me to be well done. It was a fairly large controlled study with over 300 people. The dose was adequate - much closer to what some researchers are calling for. Having the subjects take their vitamin D dose monthly rather than daily seems unusual but since D is a fat soluble vitamin it's not unheard of (I recently heard a Naturopathic Doctor tell us that he takes his D once a month). It may not be the best way to keep one's level consistently up, though. And their conclusion, although disappointing, was not overstated. I quote:

In conclusion, we report that monthly administration of 100 000-IU doses of vitamin D3 did not reduce the incidence or severity of URTIs in healthy, predominantly European adults with near-normal vitamin D levels. Further research is required to clarify whether there is benefit from supplementation in other populations and with other dosing regimens.

Similarly, after my previous rants about reporters exaggerating the dangers of vitamins in their news reports, I was pleased to see the Globe & Mail article actually tell people not to quit taking D:

That doesn’t mean you should stop supplementing with vitamin D. Mounting evidence suggests vitamin D deficiency may be linked to a number of diseases, most notably cancer, and that supplementation could be an effective way to reduce the risk. Although humans produce vitamin D through exposure to the sun, countries like Canada, that have lengthy winters and limited sunshine during those months, are increasingly advised to take vitamin D supplements.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

187 Vitamin E & Liver Cancer [15 October 2012]

Finally some good news about Vitamin E! It has been getting a lot of bad press lately, most of it undeservedly – like the study I wrote about a few months ago in column #176 which found that synthetic E raised the risk of prostate cancer.

Part of the Shanghai Men’s and Women’s Health Studies, run from 1997 to 2006 and published in July 2012 in J. National Cancer Inst., looked at liver cancer risk in middle-aged and older adults with differing vitamin intakes. They found that both dietary and supplementary vitamin E intake was inversely associated with liver cancer risk. This held true for participants both with, and without, existing liver disease or family history of liver cancer. And the results were dose dependent, meaning the more E ingested, the lower the risk. This finding agrees with previous studies which showed vitamin E is protective of the liver; it is even used as a treatment for nonalcoholic fatty liver disease (NAFLD).

Disturbingly though, it also found that for those with an existing liver disease or family history of liver cancer, high intake of vitamin C from supplements (but not from food) increased the risk of liver cancer. This is a surprise because Vitamin C has long been thought to be protective from cancer. A 1991 review published in the Am. Soc. Clinical Nutrition found that in 33 of 46 studies examined, vitamin C provided a significant protection from various cancers. But a 10 year clinical trial – the Physicians Health Study II – published in 2008 found that 400iu of E or 500mg of C did not reduce the risk of cancers, but also did not cause any harm. I would consider both doses to be low, and the E was undoubtedly pure alpha-tocopherol with no gamma-tocopherol, known from another study to significantly reduce the risk of prostate cancer.

Because of inconsistent study results like these medical scientists are reluctant to make dietary recommendations based on one or two studies.

Back to vitamin E. There are two families of E – four tocopherols and four tocotrienols – each with their own physiological functions. The best E supplement has all 8 vitamin Es, and uses the natural d not the synthetic dl forms. For more detail on this interesting vitamin family, see my December 2011 column #143.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

178 Vitamin D & Fractures [13 August 2012]

Last week I critiqued a study that concluded that calcium and vitamin D were useless in preventing fractures. Among the many oversights of the study was the low dose of vitamin D used, averaging 400 IU daily. The critique suggested that 5,000 would be a better place to start. A new study has just confirmed the significance of dosage to vitamin D’s effect on fracture prevention.

The new study, published in the N Engl J Med in July, analyzed 11 controlled studies of oral vitamin D and hip fractures. Overall those taking vitamin D had a statistically insignificant 10% reduction in fractures, agreeing with the previous study which found no benefit. However, when analyzed by dosage, those taking the highest amount of D (800 or more) had a 30% reduction in fractures which is significant but not as good as it could be. While the researchers called this “high-dose vitamin D supplementation” many still consider it to be far below optimum.

As frustrating as it is to wait for research to be carried out in the optimum range of supplementation, at least these studies are contributing something to our nutritional knowledge. What really annoys me though is the news articles reporting on such studies. Seeking sensation rather than education, journalists jump to conclusions never intended by the researchers. For example one of the headlines for the story of the former analysis read: “Panel’s Thumbs Down to Calcium/Vitamin D supplements” [Philadelphia Inquirer, June 13, 2012]. A more accurate and helpful headline would have been: “RDAs of Calcium and Vitamin D Too Low to Prevent Fractures”.

Having established, once again, the importance of adequate vitamin D levels, how can we take advantage of the last month of summer sunshine and get our vitamin D without increasing the risk of skin cancer? In short, expose skin for a short time during peak UVB period, then cover up. Details next week.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

177 Preventing Fractures [7 August 2012]

In last week’s column, I warned that when it comes to nutritional advice, not to believe everything you read in the news, and mentioned two items. I discussed a flaw in an otherwise excellent study that found that a synthetic form of vitamin E increases prostate cancer, but then concluded that high doses of all vitamin E should be avoided. Now let’s look at the other study in more detail.

In June 2012 the United States Preventive Services Task Force (USPSTF) published a statement, reported in the New York Times that, based on their analysis of 137 studies, low doses (RDAs) of calcium (1,000mg) and vitamin D (400iu) do not prevent fractures in healthy post-menopausal women and are better avoided due to a slight increased risk of kidney stones.

Not so fast! There are several problems with this analysis, pointed out in a critique by Dr. Allan Spreen of Health Sciences Institute:
• the carbonate form of calcium used in the studies is poorly absorbed so the amount may be insufficient, especially if stomach acid is weak
• the amount of vitamin D is much less than the 5,000 – 10,000 iu that we now know is optimum, especially for the elderly
• magnesium is necessary for healthy bones in about 2:1 ratio of cal:mag
• vitamin K2 is essential to direct the calcium into the bones (and along with magnesium will reduce the risk of kidney stones)
• vitamin C and trace minerals manganese, silica, zinc, copper, strontium, molybdenum and boron are also necessary for healthy bones
• a natural progesterone supplement is recommended for post-menopausal women
• finally, weight bearing exercise is essential to build and maintain healthy bones

To this list I’ll add my own observation that preventing fractures is only one of many functions of calcium and vitamin D, and not the most important one either. So even if they don’t prevent fractures there are good reasons for taking optimum amounts of both nutrients. Another factor not mentioned is that of systemic acidity which leaches minerals from the bones to maintain a healthy pH. Eating more alkalizing foods and or taking alkalizing supplements in addition to calcium will help maintain strong bones.

The last word in the New York Times article is given to a member of USPSTF, Dr. Bibbins-Domingo, whose quote reveals her lack of nutritional knowledge: “For most people there is no need for these supplements and good reason for many not to take them. Vitamin D and calcium are part of a healthy diet. Most people can achieve sufficient doses with a healthy diet”. That might be true for calcium, but unless you regularly eat fish liver, you will never achieve a “sufficient dose” of vitamin D in your diet!

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.

176 Nutrition in the News [30 July 2012]

When it comes to nutritional advice, don’t believe everything you read in the mainstream news. News reporters are seldom knowledgeable enough about nutrition to report results accurately (and have been known to jump to conclusions not intended by the studies’ authors) and reporters are certainly not competent enough to spot and question flaws in the studies. Also while medical experts are often interviewed to add caution to studies which show nutrient supplementation in a positive light, rarely are nutritional experts interviewed in a negative story. Here are two recent news stories that demonstrate these biases.

In December 2011 a study was published in JAMA that showed that vitamin E increases the risk of prostate cancer. A CBC report on the study quoted the chief medical officer for the American Cancer Society (who was not involved in the study) advising men to avoid high doses of vitamin E, but then extended his warning to all vitamins: “…excessive use of vitamins has not been proven to be beneficial and may be the opposite”. A representative of the Council for Responsible Nutrition (a supplement manufacturers’ association) was generously given the last word, reassuring the readers of the benefits of vitamin E as an essential nutrient and suggested that many Americans don’t get enough. But even he missed the biggest flaw in the study, pointed out in a critique by Health Sciences Institute, that the vitamin E used in the study was the poorly utilized synthetic dl-alpha tocopherol acetate form instead of the natural d-alpha tocopherol form. Had they used natural vitamin E, I believe the results would have been much different. The only conclusion that can be made from this study is that synthetic vitamin E should be avoided.

Then in June 2012 the United States Preventive Services Task Force published a statement that low doses of calcium (1000mg) and vitamin D (400iu) do not prevent fractures in healthy postmenopausal women and are better avoided. The result is, I’m sure, quite accurate but the recommendation to avoid them is misguided at best. I’ll explain more about the flaws in this study in next week’s column.

For more information on this or other natural health topics, stop in and talk to Stan; for medical advice consult your licensed health practitioner.