Why Write About Alternative Medicine? Part Three: Risks
Another reason to write about alternative medicine: risk. Alternative therapies have associated risks that practitioners may not inform patients about. In part one of this series (here), I linked to research that found media coverage of alternative medicine to be positive (in some cases overwhelmingly so) and to lack discussion of the risks, benefits, and costs.
Given the reluctance of practitioners and journalists to tell people about the risks of CAM, I think it is worth taking some time to blog about them.
Daily Mail On Health Tonics
The Daily Mail has an article on the top five health tonics. Let’s take a quick look. Read the rest of this entry »
Daily Mail & Self-Awareness
The Fail love to poke fun at wacky boffins, their obviously daffy ideas and their silly, irrelevant research. They also love to extrapolate from animal or lab bench studies in order to prove that wine cures cancer or that chocolate is a health food. Read the rest of this entry »
Another Report on the Dangers of Vitamins
A submission to the Journal of the National Cancer Institute has warned that Folic Acid supplementation is associated with increased risk of prostate cancer. Read the rest of this entry »
The Media Red Wine Obsession
The media seems to be very keen indeed to tell us all about the wonderful properties of red wine. Here is their latest effort. A Doctor who owns a vineyard is apparently producing red wine high in antioxidants Read the rest of this entry »
JAMA Antioxidant Studies and HSIS
A study published by JAMA has found that giving people 500mg of Vitamin C daily, Read the rest of this entry »
Vitamin C causes cancer: retro health scare
In 1998, Ian Podmore and others had a paper published in Nature. Read the rest of this entry »
Superfoods
The nutritionistas and health food stores (not to mention the press) would have you believe that there is such a thing as a ‘superfood’. There isn’t. Not pomegranate, not walnut, not even any kind of special berry harvested by Tibetan monks and recommended by Patrick Holford or Gillian McKeith. The Birmingham News ran a piece on Wednesday this week that included the claim that Read the rest of this entry »
IANT write terrible response to Cochrane – and block comments
The Irish Association of Nutritional Therapy have written a response to the Cochrane review of antioxidant pills. It’s not very impressive. Holford Watch have posted on it here: IANT and have also attempted to leave a comment (or comments) on the IANT piece. Unfortunately, the IANT appears to be blocking these comments and I haven’t been able to comment either. The following comment was stuck in moderation:
I’m afraid that not everything you have written in this response is true. For example, this: “The final exclusion involves the trials with selenium with no reason as to why. Selenium trials generally show a positive result on the disease in question when supplemented.” is simply untrue – as can be seen if you follow this link: http://holfordwatch.info/2008/04/26/irish-association-of-nutritional-therapy-giving-the-facts-about-the-cochrane-review-of-antioxidant-supplements/
When this comment failed to appear, I fired off a very brief email pointing out just one or two of the mistakes in the IANT piece:
Unfortunately, this piece: http://www.iant.ie/2008/04/18/response-to-the-recent-media-coverage-regarding-antioxidants/ contains several errors. I know that, as nutritional therapists, you will feel compelled to give the public the facts of this case and I am sure that you will amend any errors in your response to Cochrane. I look forward to reading the revised article.
Regards,
jdc.
“Many of the studies are with dosages that far exceed what is in most vitamin products.” – this has been covered by Dr Ben Goldacre in his Bad Science column in the Guardian. (1)
“The authors have excluded over 400 trials many of which have a positive outcome and have no deaths so if these were included the findings would be different.” – the study was on mortality. How exactly would those studies that do not report mortality be useful in studying mortality?
“There are no adverse risks with taking vitamin and mineral supplements that are available at the current levels.” – the levels of vitamins and minerals available at many ‘health food’ stores do have associated risks. (See again Ben Goldacre’s comments on available supplements)“Research in the UK shows that many people are deficient in various nutrients. (4) It also shows that large parts of the population come nowhere near consuming 5 portions of fruit and vegetables especially in the younger populations. There is ample research to show that at least a third of all cancer is linked to diet.” Yes, cancer is linked to diet (i.e., the food we eat – not the vitamin pills we take). However – the evidence in respect of diet and health is for fruit and vegetables, not isolated nutrients sold in pill form.
See Holford Watch [sorry for the previously broken link] and Bad Science for more on the responses to Cochrane.
Here’s a picture of a Nutritional Therapist engaging with the evidence: 
Negative Reports on Supplements
Recently, there have been a few negative reports on food supplements. The BMJ Calcium Study (PDF) was reported by the Press Association as finding that “Calcium supplements may increase the risk of heart attacks among older women”. The Press Association ended their statement with “Anyone who has been advised by their doctor to take calcium supplements to protect their bones should not stop doing so in light of this study alone without medical advice”, which seems sensible. The BBC News and Daily Telegraph reports also include this statement (which was made by Judy O’Sullivan, a cardiac nurse at the British Heart Foundation).
The BBC News, Times and Daily Mail reports also include a mention for HSIS. These were the only news reports that I could find on Google that referred to the Health Supplements Information Service. Except for Forbes, who seem to think that HSIS are sponsored by Big Pharma (yes, they really do say that HSIS is funded by pharmaceutical companies). Edit: this has now been confimed by Coracle (see comment #1).
The BBC News report said:
Pamela Mason, nutritionist and spokeswoman for the Health Supplements Information Service (HSIS), which is funded by several leading supplement manufacturers, said the study was small and had a high drop out rate.
I wondered what the point of that statement was. Did Pamela Mason consider that the study was too small to yield statistically significant results? She hasn’t actually said so, but what else would be the point of stating that the study was small? Can complaining that a particular study “was small” be a convenient way of distracting from the authors’ findings?
The Daily Mail had a slightly expanded quote which included this:
Dr Mason said the calcium intake in this study of women, averaging 800mg a day, was above the recommended UK rates of 700mg a day.
Erm… doesn’t this mean that the participants didn’t need to take Calcium supplements. That’s not very convenient for leading supplement manufacturers is it? Customers don’t need to buy their products as their intakes are (on average) already above the recommended levels as quoted by Pamela Mason. Professor Ian Reid (named as one of the study authors) is quoted in the Mail as saying that healthy older women “randomly” taking extra calcium had increased rates of heart attack. Also not very convenient for leading supplement manufacturers, but at least Ian Reid doesn’t work for HSIS. Funny how those in the alt-med industry sometimes (OK, often) appear to be closer in spirit to Spin Doctors than Medical Doctors. Pamela Mason is not the worst supplements industry spokesperson I’ve heard of, though. See here for more on another (ex-?) HSIS spokesperson.
I did say “reports”, didn’t I? Well, the Mayo clinic has released a couple of pieces recently. Hormonal Dietary Supplements can, apparently, promote the progression of prostate cancer and decrease the effectiveness of anti-cancer drugs and Mayo have also released a tip-sheet, which informs us that featured articles from the January issue of Mayo Clinic Proceedings include the effects of antioxidant supplements on cancer. For the study, two authors reviewed all randomized trials on antioxidants for cancer prevention(1968-2005) and identified 12 clinical trials with a total eligible population of 104,196. The following findings are from this study:
*Overall, antioxidant supplementation did not reduce the risk of cancer.
*Beta carotene supplementation was actually found to increase the risk of smoking-related cancers, as well as cancer mortality, and thus should be avoided, especially by tobacco users.
*Vitamin E appeared to have no beneficial or harmful effects.
*Selenium supplementation was found to lower the risk of cancer in men (not in women), but the number of trials were few and further research is required. A large trial assessing the effect of selenium in lowering the risk of prostate cancer is currently underway.
For more on antioxidants, try typing the word into the search box on Bad Science. Or try the old Improbable Science page to find the (probable) origin of the word “nutribollocks” .
Also from the Mayo Clinic, we have another snippet: a Q&A on chronic fatigue. Kenneth Berge, MD concludes his article by saying that at this time, “there is insufficient evidence of benefit to recommend any specific dietary or herbal supplements as a treatment for chronic fatigue”. This next link isn’t directly related but some supplements are, of course, advertised for their supposed energy-giving properties. Take B Vitamins, for example.
Stuff And Nonsense 