Don’t Take Your Vitamins

http://www.nytimes.com/2013/06/09/opinion/sunday/dont-take-your-vitamins.html?pagewanted=all

by ColinWright • 13 years ago

175 172 13 years ago

uokyas• 13 years ago

oh New York Times, always a fine reading in the Sunday morning, in fact very interesting. Just to show what lobbyist and the private sector are willing to do, in order to stay in business.

contingencies3• 13 years ago

Ahh, yes! The further we go from nature, the more problems we create for ourselves. The Taoists are right.

wturner• 13 years ago

A taoist would say that everything is "natural" , including man-made vitamins, cars and chemical plastics.

anigbrowl2• 13 years ago

No I wouldn't. If this were the case, it wouldn't be possible to depart from the Way.

contingencies3• 13 years ago

Ancient Taoism, ie. the real deal, emphasized living as simplistically as possible and eschewed such novelties. It later became politicized as a court tradition around the emperors of Ancient China, and underwent significant modification. It is this latter period from which much of the surviving literature derives - a common historical trajectory to most ancient philosophies.

yareally• 13 years ago

Although there may be some truth in that, even things found and used in their natural state can be problematic, such as coal.

contingencies3• 13 years ago

Taoism emphasizes locality. So if you have coal at your place and burn it, so be it. If you have no coal, use wood instead. Many people in the modern world, so far from nature, are unaware that the emissions from burning locally sourced wood for heat and cooking are actually very low... making it more attractive than other energy sources for these purposes, as long as you have some and a bit of time to collect, chop and maintain it. Transportation overheads are removed, fuel grows itself. Win. If you have no wood and no coal, be one with the natural cold :) http://nepacrossroads.com/fuel-comparison-calculator.php (Excepts transportation/purchasing overheads)

fauigerzigerk2• 13 years ago

We may have created problems for ourselves, but life expectancy doesn't seem to be one of them.

emanuer• 13 years ago

I really would like to have links to the studies mentioned, the most interesting one I could find is:

http://jama.jamanetwork.com/article.aspx?articleid=205797 — 2007, Cited by 1214

  Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. 
  The potential roles of vitamin C and selenium on mortality need further study

Who would have guessed eating too much of something could be bad for your health</sarcasm>

Hyrum_Graff• 13 years ago

Read Ben Goldacre's Bad Pharma. http://www.amazon.co.uk/Bad-Pharma-companies-mislead-patient...

andyjohnson0• 13 years ago

The Guardian recently ran an article on the same subject:

http://www.guardian.co.uk/lifeandstyle/2013/jun/07/vitamins-...

Its longer than the NYT article and contains some interesting links to clinical trial results.

joe76• 13 years ago

It's written by the same author!

anigbrowl2• 13 years ago

This article feels annoyingly incomplete or very poorly edited.

In December 1972, concerned that people were consuming larger and larger quantities of vitamins, the F.D.A. announced a plan to regulate vitamin supplements containing more than 150 percent of the recommended daily allowance. Vitamin makers would now have to prove that these “megavitamins” were safe before selling them. Not surprisingly, the vitamin industry saw this as a threat, and set out to destroy the bill. In the end, it did far more than that.

Industry executives recruited William Proxmire, a Democratic senator from Wisconsin, to introduce a bill preventing the F.D.A. from regulating megavitamins. On Aug. 14, 1974, the hearing began.

Speaking in support of F.D.A. regulation was Marsha Cohen, a lawyer with the Consumers Union. Setting eight cantaloupes in front of her, she said, “You would need to eat eight cantaloupes — a good source of vitamin C — to take in barely 1,000 milligrams of vitamin C. But just these two little pills, easy to swallow, contain the same amount.” She warned that if the legislation passed, “one tablet would contain as much vitamin C as all of these cantaloupes, or even twice, thrice or 20 times that amount. And there would be no protective satiety level.” Ms. Cohen was pointing out the industry’s Achilles’ heel: ingesting large quantities of vitamins is unnatural, the opposite of what manufacturers were promoting.

A little more than a month later, Mr. Proxmire’s bill passed by a vote of 81 to 10. In 1976, it became law. Decades later, Peter Barton Hutt, chief counsel to the F.D.A., wrote that “it was the most humiliating defeat” in the agency’s history.

Well, what more did the industry do than destroy the bill? After making such a strong clear case for regulation, how did the bill forbidding it pass with such an overwhelming majority? Were there payoffs, or was it something the vitamin makers said in testimony, or did they gin up a massive publicity campaign, or what? I'm quite frustrated at how little information this article contains.

On the plus side, I'm glad that I've stuck to getting my vitamins from food rather than supplements.

dm24• 13 years ago

Why hasn't this issue been revisited in congress? Shouldn't everything be revisited very X years to ensure that the law is still relevant with current information?

eli• 13 years ago

The are a great many laws I would prefer the current Congress not revisit.

DiabloD3• 13 years ago

The article does not seem to follow the headline. Supplement manufacturers going on the offensive has nothing to do with the safety of vitamins.

DanBC5• 13 years ago

Well, what more did the industry do than destroy the bill?

I don't want to talk about a monolithic "The Industry". But there's no doubt that some companies and people involved in mega-dosing or in vitamin supplements are evil. I don't mean wishy-washy "making lots of money and being a bit cynical" kind of evil, I mean actually evil.

Mathias Rath has probably caused the death and infection of very many people in South Africa because of his AIDS denialism and promotion of vitamins as a cure for AIDS. (https://en.wikipedia.org/wiki/Matthias_Rath)

(http://www.irinnews.org/report/38577/south-africa-controvers...)

(http://www.irinnews.org/report/78739/south-africa-tac-prevai...)

Remember that this was during mid to late 2000s when HIV / AIDS was a significant killer in South Africa, infecting nearly a third of the population (http://www.avert.org/south-africa-hiv-aids-statistics.htm)

Patrick Holford has written books with titles like "Food is better medicine than drugs: your prescription for drug free health" - people are turning away from conventional medicine and using multivitamins. He's not as scummy as Rath, but he's pretty scummy. Selling vitamins as a cancer-cure to desperate people when there's no evidence that it works is unpleasant.

just2n3• 13 years ago

Please log in.

Can we do something about paywalled links here, please? This is the 5th one on the front page today.

kintamanimatt• 13 years ago

Does incognito mode still work to get around the NYTimes' paywall?

josscrowcroft• 13 years ago

For me, yes. When they say "You have passed the maximum reading limit", it's incognito-time

ColinWright• 13 years ago

Perhaps someone can help you with that, but I'm not logged in, have never logged in, don't intend to register, and don't get the "Please log in" message.

I wonder what's different between your setup and mine.

just2n3• 13 years ago

In order to access our Web site, your Web browser must accept cookies from NYTimes.com.

In that case, I have no interest in any of their articles.

ck23• 13 years ago

With NYTimes, I find if I add ?_r=0 to the end of the url it works.

dm24• 13 years ago

So... should I take a daily multivitamin or not?

shin_lao2• 13 years ago

No, you should have a balanced diet instead.

Vivtek• 13 years ago

Eat food. Not too much.

dm24• 13 years ago

Hypothetically, let's assume that I don't eat vegetables but once a week. Should I take a multivitamin daily?

oblique632• 13 years ago

Why not both? Better yet, why not try to figure out[1] what you're deficient in, and supplement that (either by diet, or supplements as needed)?

It is silly to just assume everyone has the same dietary needs and can be given broad, vague advice like "eat a balanced diet", when that could easily be a full-time job itself and all that might actually be lacking is just a few micronutrients, or just have a subtle intolerance to something that needs to be removed from your diet. These problems are not as uncommon as you may think, and there is too much variation to not only suggest one 'fix-all' solution, but to assume that one can even be had right now. Learn about your specific needs and treat those; don't go off of random anonymous internet comments or bloggers looking for page views.

[1] One possible way to do this: http://www.spectracell.com/patients/our-tests/patient-micron...

relix9• 13 years ago

First of all, the author sells a book about vitamins being bad, so he's probably not being objective about it.

I'm also biased in favor of taking daily supplements, because I take daily supplements and don't want to feel like a fool. That said, here's some analysis of his sources:

Most of the articles he (doesn't) link to are about harmful effects of beta-carotene and vitamin A, which coincidentally turn out to be mostly the same thing, just in a different form. Checking out the one article I found [1], they gave 30mg of beta-carotene (16K UI), and 25000 UI of retinyl palmitate, which converts to a total of 41000UI of vitamin-A, or 800% of the recommended daily dosage.

That dosage is insanely high. I have a very good "mega multi" vitamin, and it only contains 200% of vitamin-A, because it is well known that vitamin A and vitamin D are one of the few vitamins that are actually harmful at large doses, and you can get poisoned/die from overdoses. It's the reason why you don't want to eat polar bear livers. To OD on vitamin A is quite easy, with effects being seen starting at daily 21000 UI doses. So no multivitamin pills actually contain that high of an amount of vitamin A. I find it strange that he's not talking about specific brands, probably because none of them contain the high amounts that are used in the articles he talks about.

It doesn't surprise me that taking 41000 UI has adverse effects, since it's known that this is already well over OD limits, and is especially risky for smokers, who have a lower OD limit.

All in all, the reasons he puts forward why mega doses are bad, are not relevant to consumer vitamin pills because the doses are not in the same ballpark. I would also like to see the amount of lives saved because of the pills - much like airbags and car belts, there might be people who die from using them especially, but there might be many more people saved as well, turning it into a net profit.

[1] http://www.ncbi.nlm.nih.gov/pubmed/15572756

lake995• 13 years ago

I agree entirely. Also, instead of giving proper references to papers, the author takes the scumbag approach of being vague "in 2004, a review of 14 randomized trials for the Cochrane Database found that the supplemental vitamins A, C, E and beta carotene, and a mineral, selenium, taken to prevent intestinal cancers, actually increased mortality."

That, alone, should qualify this article as tripe.

jstsch• 13 years ago

This is an article in the NY Times, not a scientific paper. Providing all those direct references would not make for good reading. The Cochrane Library is a very reliable resource, and I think it's valid to assume that the author is not simply making this up.

DanBC5• 13 years ago

The Cochrane Review is a widely respected organisation who publish careful, reviewed, systematic meta-studies.

Here's a link to a metastudy about gastro-intestinal cancer and anti-oxidant supplements. (http://summaries.cochrane.org/CD004183/antioxidant-supplemen...)

That introduction is very clear. it is unambiguous. "Trial quality was exceptionally good". "Based on properly designed and conducted randomised clinical trials, convincing evidence that beta-carotene, vitamin A, vitamin C, and vitamin E or their combinations may prevent gastrointestinal cancers is not found [...] These antioxidant supplements even seem to increase mortality."

Here's the study for lung cancer. (http://summaries.cochrane.org/CD002141/antioxidant-drugs-for...)

Note that these people would really want to find effective cheap treatments for cancer, so it is in their interest to find that vitamin supplements work.

latch2• 13 years ago

"First of all, the author sells a book about vitamins being bad, so he's probably not being objective about it."

That's a cynical glass-half empty perspective. The other way to look at it is that he might be an expert...

For example, assuming this is the same Paul Offit...you could claim that his book on the importance of vaccination makes him non objective, which would be a silly claim given that he's widely considered a leading expert in the field of vaccination.

Edit:

I'm going to get a little more personal because, for some reason, your opening line really bothered me.

You're dismissing someone's opinion, in a field for which he holds an M.D., where he spent 25 years of his life building a vaccine against a disease which kills 600 000 children a year . You've been barely alive for that period of time and you've studied computer science....the guy's an expert. Doesn't make him right...but there's no reason to disrespect him by assigning him false motives.

relix9• 13 years ago

I'm just adding to the body of facts here. There's an almost identical article by him in the Guardian linked below which contains a plug to his book. It feels a lot like a marketing campaign for his book which will be released next week.

Edit: what do any personal facts matter here? Could you please stay on-topic and not make this about me vs him, but more about the content of his article? On top of the logical fallacies[1][2] you're committing, I feel really creeped out that you're posting personal details about me.

[1] https://yourlogicalfallacyis.com/ad-hominem

[2] https://yourlogicalfallacyis.com/appeal-to-authority

tantalor• 13 years ago

"The other way to look at it is that he might be an expert..."

He is definitely an expert. From Wikipedia, he is a pediatrician, co-inventor of a rotavirus vaccine, and published more than 130 papers in medical and scientific journals.

http://en.wikipedia.org/wiki/Paul_Offit

codersteve4• 13 years ago

He could be writing the book because he wants to make people aware.

I don't understand why people insist on taking supplements when they have no medical reason to do so.

From the bottom of the page:

"Paul A. Offit is the chief of the infectious diseases division of the Children’s Hospital of Philadelphia"

relix9• 13 years ago

I can give you my reason: I take supplements because I'm positive I'm not getting 100% of my necessary vitamins from my diet/sunlight. Also because on some days I might need more, and on others less, so I make sure that I take enough for even the most "vitaminy-requiring days" (i.e. after infection but before symptoms of a disease, or after workout). That's why I take a dose that's higher than the RDA. There's almost no evidence contrary to taking higher-than-normal doses of vitamins, except for the ones that get stored in fatty acid such as VitA and VitD. For those I watch out that I don't take too much. On the other hand, there's a lot of studies done where people deficient in vitamins have lots of adverse health effects which they may not even be aware of. I figured that there's lots of potential benefits to gain from taking vitamin supplements, and if it doesn't work then I'm only out money.

brown9-22• 13 years ago

First of all, the author sells a book about vitamins being bad, so he's probably not being objective about it.

I think you are reversing the cause and effect here. You assume that because he is releasing a book on this topic, therefore his opinion has been molded to fit the book. But you should be asking where the opinion behind the book came from originally.

Meanwhile, the reverse can also be true - the author, a highly credentialed doctor, started out objective on the topic and after years of research has come to the conclusion that he advocates in his article and book.

The focus here on "being objective" is a bit odd - not every issue has two sides that are both equally correct. The fact that someone has done all the research and looked at years of studies and has arrived firm conclusion does not automatically make him or her an unfair observer.

In fact, that's not even bias! Bias is refusing to consider any other viewpoint even with evidence.

I do agree with you though that the article would be better if it was more clear about the dosages in the studies. It's advice comes off as "vitamins are dangerous" rather than "megadoses of vitamins are dangerous".

giardini6• 13 years ago

If you're a scientist and objective observer you publish papers on a topic. You write a book to make money on that topic.

gruseom• 13 years ago

First of all, the author sells a book about vitamins being bad, so he's probably not being objective about it.

Ok, but that standard applies to any researcher who receives grant money or a salary. In fact, it's so high a standard that objectivity can be claimed by no one. Which is probably accurate, but not very useful for making distinctions—it's a case of what Hegel called "the night in which all cows are black".

readme• 13 years ago

Of course he's not being objective about it! He's being sensationalist.

If you go and look for studies on vitamins increasing mortality, you will find them. If you look for studies on vitamins increasing longevity, you will find them.

Seems the author is choosing to present only the former, though!

raverbashing• 13 years ago

Ok, what looked liked a passable article shows some new things:

"The likely explanation is that free radicals aren’t as evil as advertised. (In fact, people need them to kill bacteria and eliminate new cancer cells.) And when people take large doses of antioxidants in the form of supplemental vitamins, the balance between free radical production and destruction might tip too much in one direction, causing an unnatural state where the immune system is less able to kill harmful invaders. Researchers call this the antioxidant paradox.""

I wouldn't be worried at 150% vitamin dosages, worry if it's 1000% of the daily dosage (and some people take huge doses of Vitamin C with no major side effects. But if you do that with Vitamin A, yes, this could be very troublesome)

ekianjo• 13 years ago

Somebody should tell Kurzweil about this.　"Kurzweil does not believe in half measures. He takes 180 to 210 vitamin and mineral supplements a day, so many that he doesn't have time to organize them all himself." http://www.wired.com/medtech/drugs/magazine/16-04/ff_kurzwei...

gbog2• 13 years ago

About these supplementary pills I think the advice of Taleb is very good:

- When there is a very strong reason to medicate or do surgery, do it immediately.

- When it is just for convenience, don't do it. The long term risks are unknown.

His diet advice is "don't ingerate anything that has been invented in the last 50 or 100 years", so wine: yes, Coke: no, vitamin pills: no, etc.

However in case of a cancer with a very bad diagnostic, he would try even the newest unverified cure.

I think this advice should be heard in the US where so many people seem to fill their stomack with aliments that did not exist 50 years ago (processed food, chocolate bars, soda, pills being the worst).

(I am rephrasing)

patrickk2• 13 years ago

Can you link to where he says that? I'd like to read more, it sounds interesting.

Also, coke (both the drug and the soft drink) is well over 50 years old, but I understand the point you're getting at with being wary of consuming substances that are not well understood.

On a side note, some people who argue in favour of legalising cannabis are also argue in favour of legalising cocaine, as they reckon keeping it illegal does more damage than legalising it (Mexican cartels). In places like Bolivia, people chew coca leaves as a natural stimulant (cocaine comes from processed coca leaves). I'm not sure where I stand on legalising cocaine though, I can see two sides to the argument.

gbog2• 13 years ago

I read this in his Antifragile book.

justin664• 13 years ago

He's basically been doing the paleo diet (and the associated exercise, short duration sprints and weight lifting) for a while now. It doesn't seem hugely compelling to me, except for the reduction of all the excess carbs that come from a modern diet, which is a really good idea. (Pretty much everyone except the nutty nutrition skeptics - have a smoke, correlation isn't causation guys! - in this thread would categorize that as a win.)

giardini6• 13 years ago

In his recent book AntiFragile, Taleb states that he drinks no beverages that aren't at least 1,000 years old. In particular, he admits to drinking coffee, water and wine.

martingoodson• 13 years ago

Paul Offit seems to be irrationally biased. In his longer guardian piece on the same topic he is extremely selective in his referencing of the scientific literature. This is his summary of the findings on one popular herbal treatment for depression:

"Depression is a serious illness; to treat it, scientists have developed medicines that alter brain chemicals such as serotonin. [...] Alternative medicine practitioners, however, have a better idea – a more natural, safer way to treat depression: St John's wort. Between November 1998 and January 2000, 11 academic medical centres randomly assigned 200 outpatients to receive St John's wort or a placebo, finding no difference in any measure of depression."

He omits the fact the same study also did NOT detect any effect of Sertraline/Zoloft (one of the very medicines he refers to so approvingly):

"Neither hypericum nor sertraline could be differentiated from placebo on the primary efficacy measures."

This points to a lack of statistical power in the study (which the authors of the study acknowledge).

He also omits to mention the many studies showing st john's wort to be as effective as SSRIs, with fewer side effects (eg see the cochrane summary here http://summaries.cochrane.org/CD000448/st.-johns-wort-for-tr...).

I don't trust this author.

adammichaelc• 13 years ago

The author has a pretty big conflict of interest that he doesn't disclose. He invented one of the major vaccines, regularly consults for pharmaceutical companies, etc. If an alternative to vaccines was found to be effective in preventing or treating diseases, he would have much to lose.

driverdan2• 13 years ago

He would have very little to use. He helped create one vaccine. His royalties are not that significant (according to him). He'd have just as much to gain from scientifically valid alternatives if they existed. He could do the same as he does now (treat patients, speak, and write) with any valid disease treatment.

fauigerzigerk2• 13 years ago

Interestingly, the opposite is true for vitamin D. For years, study after study shows that most people are severely deficient in vitamin D and that supplementation helps. Yet, officially recommended doses are way below the levels that scientists recommend.

relix9• 13 years ago

And importantly, a lot of countries do have laws against mega doses, causing pills with more than 150% of RDA to be illegal, making it really hard to get a decent supplementation, especially during winter.

PommeDeTerre• 13 years ago

In a case like that, what prevents somebody from taking more than one pill at the same time, if one pill alone is insufficient?

paul_f• 13 years ago

Do not use this article as an reason to stop taking Vitamin D. Totally different thing altogether. This article demonstrates the problem with calling all of these things "vitamins."

DanBC5• 13 years ago

The article gives calm, sensible advice.

It misses the importance of (normal quantities of) Vitamin D. Many people live in places where they're unlikely to get correct amounts of Vitamin D, especially because of the (correct) caution about sun exposure and the move away from dairy fats.

For those people a Vitamin D supplement is a good idea.

Also, women wanting to become pregnant should strongly consider folate supplements.

And children probably need (correct child dose) multivitamins up until about 4 or 5 years old.

EDIT: Some sources.

UK National Health Service: (http://www.nhs.uk/conditions/pregnancy-and-baby/pages/vitami...) - notice how it stresses the importance of healthy diet, but also advises for Vitamin D supplements.

Scotland: Warning over Vitamin D levels (http://www.bbc.co.uk/news/uk-scotland-11355810)

codersteve4• 13 years ago

It's simple enough to get a test for deficiencies, then take the specific supplements you need, if you need them.

shabble• 13 years ago

Is it simple like a urine pregnancy/drug screen test that gives quantitative recommendations?

Or is it more like arrange with your doctor to draw some blood, have it tested, then get an expert appraisal of the results which recommends a set of supplements?

Either way, it should probably be done periodically, to account for changes in diet and personal circumstances.

I wonder if this is something that personalised medicine could start with -- A machine which combines the blood analyser, expert system for determining requirements, and a set of dispensers that load the exact quantities into capsules while you wait. Ideally it'd work with something like a glucose test finger-prick sample, but I have no idea how much blood you need to run some of the more complex blood analyses.

alanctgardner22• 13 years ago

Living in the Great White North (Canada), pretty much every health group ever recommends a vitamin D supplement because we get so little sunlight. As an office worker, this goes double for me.

Also conspicuously missing from their list are vitamin B supplements; as a vegetarian I take B12, but they don't make any comment on whether this could have similar effects.

pron13• 13 years ago

Not taking one side or the other, it's important to note that when it comes to nutrition, we know very little. Or rather, we know many disparate facts but very little about how they interact. The reason is that there are very few good "unit tests" for human physiology, and we're not even sure about what they really mean (for example, current research suggests that what we thought we knew about the significance of blood cholesterol levels might be wrong). And if all we have are "integration tests" (like mortality rates), the number of variables affecting them becomes so huge, that in order to get truly statistically significant results we would need to conduct randomized trials on very big populations. Add the difficulty of conducting a double-blind randomized nutrition trial even on a small population, and you get results that have little actual "results" (although a randomized double-blind trial with vitamin pills is possible).

When John Ioannidis proved that most published medical research is false[1], he singled out genetics and nutrition[2] as the two most problematic fields, where very, very few findings are true. The fact is that we know alarmingly little about what constitutes a healthy diet. Let me clarify: we know hardly anything about significant difference in total health one relatively "normal" diet has over another. Ioannidis's advice: completely ignore any nutritional "scientific" claims because they are anything but. Any supposed claims for "healthy" eating are no more than wishful thinking, pseudoscience and good-old snake-oil salesmanship.

What is interesting from a scientific point of view, and this is one subject we know a lot more about than actual nutrition, is why people who are otherwise scientific minded skeptics are superstitious when it comes to nutrition (if you believe that eating more green vegetable or less, consuming more vitamin C or less, more saturated fat or less is actually better for you, then you are superstitious, unless you are knowingly placing a scientifically unfounded bet on one diet over another).

Obviously, the well-known psychology of magical thinking applies to everyone, and even skeptics are not immune to it (Charles Darwin, if one anecdote about him is correct, quite amazingly identified the effect magical thinking had on his own research, and took measures to counteract it). But why is food such a focus of superstition among skeptics? It probably has to do with their political leaning.

Jonathan Haidt hypothesizes that the value of "purity" is ingrained in human existence, and every society seeks to fill it with particular meaning[3]. Because liberals wholly reject giving "purity" sexual or racial content, they choose to purify themselves through health, and in particular, food. It seems that people have such a strong desire to feel pure, that those that cannot achieve it through religious means, try to achieve it with food. And because food is, after all, subject to scientific study (though mostly bogus), it gives that little something to grab onto and construct magical thinking around.

Consider this if you don't believe me: pick one scientific nutritional finding that you particularly like, and have chosen to adhere to. Let's suppose that the finding is true as published. Now, look at what statistical effect-size that particular research claims your chosen diet has. For example, by how much does it prolong life? 10%? 5%? 3%? Or by how much does it reduce the risk of getting a particular form of cancer? Does it take it from 1/100 to 1/10000? Or, perhaps, from 1/1000 to 1/1200?

Now think if in other areas of life, such effect-sizes would change your behavior as much.

Theres definitely a lot of psychology when it comes to people's diets. Science? Not so much.

[1] http://www.plosmedicine.org/article/info:doi/10.1371/journal...

[2] http://www.theatlantic.com/magazine/archive/2010/11/lies-dam...

[3] http://www.ted.com/talks/jonathan_haidt_on_the_moral_mind.ht...

nopinsight• 13 years ago

What counts as scientific evidence has fairly high standard. What we know may not reach that level of rigor, but isn't it still a bit more than 'very little'.

If, say, it's 80% (rather than 95%) likely that eating more than 4 servings of fruits and vegetables per day helps reduce your chance of having cardiovascular diseases by 35%, and you don't mind the food group anyway, why shouldn't you try?

In any case, there are very few (or no?) studies that say eating a lot of vegetables and fruits (within reason) will cause you health problems.

A principle of entrepreneurship is that whenever a bet yields either positive or neutral results, you should do it. Why shouldn't this principle be applied to such an important area as our health and wellness?

pron13• 13 years ago

There's actually evidence to support that eating fruit is quite detrimental to your health, as modern fruit contain so much sugar. What are you eating fruits for? Water? Vitamins you can get from meat anyway? A lot of people say fruits are bad for you.

Now, I'm not saying you should or shouldn't do one thing or another when it comes to nutrition. All I'm saying is you should be aware that it's little more than superstition and magical thinking. It's very hard to resist magical thinking, but it's often good to know when you're doing it. Sometimes doing things with your eyes open is better than doing them with your eyes shut. Although in this case I'm not 100% sure about that: there's clearly a lot of (positive) placebo effect at the cause of many anecdotal reports about nutrition, and knowing that it's mostly superstition may negate it.

eru4• 13 years ago

A few broad facts are well known, but our knowledge is still quite limited.

A principle of entrepreneurship is that whenever a bet yields either positive or neutral results, you should do it. Why shouldn't this principle be applied to such an important area as our health and wellness?

It's not only positive or negative expected value, but rather that the uncertainty (i.e. variance) outweighs the expected value of almost all detailed propositions.

After you took care of the simple and uncontroversial things, e.g. adequate amount of calories, enough iron etc, there's not too much we know how to optimize in general.

beagle310• 13 years ago

When it's a neutral thing for you, sure, why not. However, most things about nutrition are NOT neutral.

Is salt bad for you? (hint: unless you have a very specific hypertension condition, all the bad things you heard about salt are not relevant to you)

How much is too many eggs per day? (hint: no known limit. Cholesterol from eggs was never shown to be a problem)

Well, how about butter and fat? (hint: right kind of butter is good for you, as is the right kind of fat)

But surely, saturated fat is bad for you! (hint: no proof of that)

But at least bacteria and dirt are bad for you, I'm sure of that! (hint: life span is correlated with eating lots of fermented - i.e. bacteria laden foods. Also, people who work in sewage have higher life span and less illness overall)

You are taking tens or even thousands of bets based on bogus research without even knowing that. It is not unreasonable to assume that washing your hands all the time and keeping your house clean significantly raises the probability of autoimmune disease.

And really, if you go through nutrition literature and try to trace the knowledge to repeatable and demonstrable experiments, you'd agree with "very little". e.g., the calorie marking system used on foods is based on bomb calorimeter experiments (which you can debunk at home) and atwater factors (which have been shown to be grossly inaccurate, as in tens to hundreds of percents).

morsch2• 13 years ago

Interesting. But is obsessively eating healthy really tied to political leanings? As far as I can tell it seems to be mostly a upper middle class thing (perhaps coincidentally the class mostly everyone believes they're in).

That said, I suppose I could make the same argument that many people with a certain political leaning do engage in self-mandated food purity by eating vegetarian or vegan. Which sound reasons and very little magical thinking in terms of the economics of food.

pron13• 13 years ago

sound reasons and very little magical thinking in terms of the economics of food

First, there isn't much logical thinking involved in veganism or vegetarianism. At their best, they're about ethics (which I certainly respect). At their worst, they make some very dubious claims about te economics of food and the environment.

But either way, note that people make significant and probably burdensome changes to their lives when it comes to upholding morals pertaining to food. I think that more (liberal) people would go a longer way making actual life changes when it comes to food than just about anything else. They might explain that the things you actually put into your body are the things you should care about most. Only there's little evidence to suggest that's the case. It is much more probable that national policies like increasing minimum wage or reforming education would have a bigger (though indirect) effect on your personal well being than optimizing your diet (as long as it's more or less "normal").

All religions, in this case the healthy diet religion, must not rely on facts in order to gain followers; they must rely on gut feelings, because gut feelings are much more powerful than proof when it comes to motivating life changes. And we just naturally feel that ingested food has to have a major effect on our health and general well being. It just makes sense, right? But, at least in the current state of scientific knowledge on the subject, that intuition is just superstition. After decades of research there's little consensus even on what makes us fat, let alone more subtle or indirect effects diet may have on our health. In fact, it's very probable that even if one day we do know exactly what's healthy to eat and what isn't, and at what quantities, the actual effect-size on our health will be quite small. It's quite possible that within some sane bounds, what food we eat simply does not determine our health to any large degree.

stiff• 13 years ago

What is interesting from a scientific point of view, and this is one subject we know a lot more about than actual nutrition, is why people who are otherwise scientific minded skeptics are superstitious when it comes to nutrition (if you believe that eating more green vegetable or less, consuming more vitamin C or less, more saturated fat or less is actually better for you, then you are superstitious, unless you are knowingly placing a scientifically unfounded bet on one diet over another).

There is certainly lots of superstition in all of our beliefs, but you overblown your thesis to the point of being a bit ridiculous...

First of all you present it as "all or nothing" choice, like either you had full knowledge from a scientific study or otherwise there would be absolutely no reasons to choice one alternative over the other. In the absence of absolutely certain evidence there are still more or less "probably good" choices given the informations we have and there are also heuristics that might be helpful.

You also assume that the only way to navigate nutritional choices is through statistical studies. There are other ways though, we have a decent understanding of the physiology of the human body and its biochemistry and we happen to know for example that the moving of waste products through the intestines is greatly helped by fiber consumption, so I don't think eating green vegetables is particularly superstitious.

With your point about "purity" you wander into psychoanalysis, which is rather funny considering your supposedly hyper-rational stance.

pron13• 13 years ago

It's not all or nothing, obviously, but many people's dietary choices (especially those who consider themselves most health-conscious) go far, far beyond anything that's supported by science. My claim is that most dietary choices beyond a reasonable intake of calories and more or less "normal" food is magical thinking and worse -- it's pseudoscience. This includes what we know about human physiology. We know how some systems work, but we don't know much about how they interact. Suppose fiber helps to move waste through the intestines. But does it have other effects as well? Is it good overall? And suppose it is good overall -- just how good is it? Is it even worth the effort of consciously increasing your green vegetable consumption by 10%? This last point is the crucial one, because I'm trying to show that when it comes to food, some people actively change their behavior based on conjectures, or little evidence.

BTW, what I like most about John Ioannidis's work is that he not only proved theoretically that most medical research is false, but he showed it empirically: He showed that a large percentage of papers in the best regarded medical journal turned out to either be completely false, or to have a much reduced effect-size. Some of these papers suggested practices that, at the time, were considered "probably good" choices, and have since been shown to be anything but.

What I was saying about purity had nothing to do with psychoanalysis. Not all psychology and anthropology is psychoanalysis, and I suggest you take a look at Haidt's research. At the very least, it's thought provoking.

Lastly, I'm not taking a hyper-rational stance. I've long ago realized that I, like all people, am far from rational. I am superstitious myself, and about stranger things than food. I just think that the rise of the food religion among the educated liberal elite is interesting. I am very much interested in the history of religion and mysticism, and I always find it fascinating how magic works its way back into our lives -- contrary to Max Weber's assertion -- no matter our background. Haidt's theory of values is one especially interesting framework through which to examine this phenomenon.

sutro• 13 years ago

Steve Jobs seems to have indulged in a surfeit of magical thinking about nutrition. It might have killed him.

http://www.psychologytoday.com/blog/naughty-nutrition/201201...

ErikAugust• 13 years ago

Extreme fructose diet. The company was even named Apple.

influxed• 13 years ago

This quote alone shows why the author has zero credibility:

"[...] environmental toxicity and genetic proclivities would have contributed as well. Certainly, Jobs was exposed over the years to massive bombardment from WiFi and other electromagnetic fields (EMFs)."

Digging deeper, it appears her career as an author and nutritionist is based on the idea that eating soy and vegetarianism is bad for you. Correlation is not causation, but it has long been known that vegetarians live longer.

I'll put more faith in peer-reviewed scientific journals than an author who writes in a magazine called "Psychology Today."

nbouscal3• 13 years ago

I really like your analogy to unit tests and integration tests. It makes me wonder if the Soylent ‘experiment’ might provide a better means to do that. Rob has already written about a few times where he was missing something in his formula and was able to detect specific problems and respond to them. Sounds pretty close to being unit-testable at that point.

cell303• 13 years ago

I really dislike the unit test and integration test analogy. It is based on the assumption that the human body has something in common with a computer program - or anything man-made for that matter. This is clearly not the case. We tend to think of ourselves in terms of whatever our current lead technology is. It has been like that before [1]. While it is certainly psychologically comforting it becomes dangerous when we act based on what really is somewhat of an arbitrary model.

[1] http://webadventures.at/2007/06/17/der-mensch-als-industriep...

pron13• 13 years ago

There is no way anyone can make several accurate observation about nutrition at our current stage of knowledge about physiology, let alone be able to "hack" it. It's like someone saying they're working on a warp drive or a teleporter. It could happen some day, but probably far in the future.

Actually, the warp-drive/teleportation problems might be easier, because we'll probably know when we get there. With nutrition, there's little evidence to suggest that a theoretically perfect nutrition would result in much improved health over sub-par nutrition. We don't even know that nutrition has a strong effect on health at all (other than eating poison, or few other truly well-known facts).

mekoka• 13 years ago

I think you're too loosely using the terms "superstition" and "magic".

This is Merriam-Webster's definition of superstition: 1 a : a belief or practice resulting from ignorance, fear of the unknown, trust in magic or chance, or a false conception of causation b : an irrational abject attitude of mind toward the supernatural, nature, or God resulting from superstition 2 : a notion maintained despite evidence to the contrary

There are indeed diets that are superstitiously motivated (don't eat pork because it's an impure animal, don't eat cows cause they're sacred, etc), but you're throwing everything in the same pot, liking religious motives and decisions by rational minds to eat or omit certain food items, based on observations and deductions (albeit sometimes limited and flawed) of effect and causality. If anything, the latter is but an attempt at building a framework toward a saner nutrition.

If we were to listen to you, we should wait until everything has been discovered about food and physiology to start making up our minds as to what is good or bad to ingest. At which point I guess what you keep calling "magic" then becomes science. This tendency of wanting to be absolute is a bit naive. No body of knowledge works like that. Just because our understanding of a topic is patchy, doesn't exempt some connections to be made that can be built upon to stitch up a gradual and more complete understanding. Which, if I observe how nutrition has evolved, is exactly what's happening.

Nothing magic there.

specialist• 13 years ago

I have chronic life threatening illnesses. I've had equal numbers of good doctors and bad doctors. I'm deeply skeptical. It's wicked hard for me to figure out what's going on in my body. And self-reporting is notoriously unreliable.

Until science catches up, I think we should all "try and see", compare notes, and keeping searching until we find solutions. I've been patient advocate for many others; this is old advice.

---

About two years ago I tried the Four Hour Body strategy. My goal was to lose weight. I was astonished when my psoriasis started to clear up. The important part: I established cause and effort by stopping the nutrition (bad eating during business trips) and the psoriasis comes back with a vengeance. I have no idea why it works. Because I'm eating more veggies? Because I'm avoiding wheat? All I know is it works.

Since then, I've had steady improvement while sticking to the troglodiet (tm), resumed eating meat and lotsa more of veggies. More or less following Dr Terry Wahls "Minding your Mitochondria" strategy, with occasional treats (cheesecake!) so I don't go insane.

Most recently, my gf persuaded me to try her naturopath doctor. From prior experience, I think naturopaths are quacks at best. But I also think that the good bits of naturopathy will eventually just be called "nutrition".

I presented specific complaints to this ND, which my other doctors haven't been able to assist with. I'll give an non-embarrassing example. My muscles never relax. I'm now super tone without exercising. It's fantastic. But I also have zero energy. I've been taking magnesium. I've seen a neurologist. I've tried some other stuff.

So the ND says the magnesium isn't getting to my muscles because I'm not eating enough essential fatty acids. Tells me to eat more of such and such and take some pills. Sure, why not, can't hurt.

Similar story for the other conditions I have.

Well, I'm about a month into this new regiment. Huge improvement on one issue, modest improvement on two others, and no change with the fourth.

In a few more months, I'll stop the regiment, see if my conditions get worse. I don't want to be taking pills and such without benefit.

---

I agree with everything you've written, but we should continue to experiment and ask questions, until we find solutions.

ck23• 13 years ago

I used to get really bad headaches like every other day.

One extra busy and strange week I forgot to take my multivitamin a few days in a row.

And it dawned on me my headaches went away.

Now I've stopped taking my multivitamin for a year and I've only had headaches I can count on one hand.

Tried another brand multivitamin and same headache problem happened so I'm done with that.

eru4• 13 years ago

I wonder whether it was a specific component, and if yes, which.

ck23• 13 years ago

That was my thinking too but there are so many things in them, doing it scientifically would be quite a feat and not sure how to go about it.

For all I know it might even be the inert compound binding it.

corresation2• 13 years ago

The vitamins that most take provides fractional amounts of the RDA -- at most 100% (e.g. Centrum, etc.) -- and is truly intended to be an offset of an imperfect diet. Using the case of mega-doses, especially against compromised peoples, as the demonstration of the dangers of normal supplementation is dishonest, just as it wouldn't be reasonable to discourage water consumption through the example of someone consuming tens of gallons a day.

I am not speaking of this specific author, a very respected researcher, however there are many who essentially make bank on the anti-vitamin bandwagon (never underestimate the motivation of getting broadly quoted and referenced, which is a likely outcome when you "prove" counter-intuitive conclusions), and the techniques are often highly dubious.

One of the most common tactics to discourage vitamin use is to compare the mortality of general vitamin supplementation users and those who don't, ignoring the immense self-selection bias that comes into play. Namely that people in compromised health or at risk often flock to vitamins -- wrongly -- as a snake-oil fix for ailments, thus providing plenty of data in the "mortality" side.

I take the odd multi-vitamin, primarily on days where I know I've eaten terribly. I do supplement Omega 3s daily.

300bps• 13 years ago

I used to take daily Centrum. Had a few years where my liver enzymes (AST/ALT) were elevated. Doctor asked if i took a multivitamin to which I told her I did. She said stop taking it. That was about 8 years ago and I haven't had an elevated liver enzyme test since then. She said some people have a really hard time processing all those vitamins in their system and it hurts their liver.

Now I just take Vitamin D (tested as mildly deficient) and Omega 3 from krill.

corresation2• 13 years ago

Makes sense, especially given the fluorescent yellow urine that often comes shortly after taking a vitamin (the liver/kidneys working hard to eliminate something, which is telling enough). It seems like vitamins would be improved to come in smaller, multiple-doses (though that becomes less convenient) -- the one I occasionally take is dosed as two pills through the day to hit the 100% mark, and it has removed the nuclear pee response -- or slowed delay, etc.

javiermares• 13 years ago

For what it's worth, regarding the multivitamin and prostate cancer study: http://www.rayandterry.com/blog/prostate-cancer-and-vitamin-...

pdevr• 13 years ago

All the referenced studies (none of them are behind a paywall):

The Beta-Carotene and Retinol Efficacy Trial: incidence of lung cancer and cardiovascular disease mortality during 6-year follow-up after stopping beta-carotene and retinol supplements.

http://www.ncbi.nlm.nih.gov/pubmed/15572756

Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis.

http://www.ncbi.nlm.nih.gov/pubmed/15464182

Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality

http://www.ncbi.nlm.nih.gov/pubmed/15537682

Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial.

http://www.ncbi.nlm.nih.gov/pubmed/15769967

Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study.

http://www.ncbi.nlm.nih.gov/pubmed/17505071

Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases.

http://www.ncbi.nlm.nih.gov/pubmed/18425980

Dietary supplements and mortality rate in older women: the Iowa Women's Health Study http://www.ncbi.nlm.nih.gov/pubmed/21987192

Effect of Hypericum perforatum (St John's Wort) in Major Depressive Disorder A Randomized Controlled Trial http://jama.jamanetwork.com/article.aspx?articleid=194814

mark_l_watson2• 13 years ago

It is nearly impossible to know definitively what to eat, but it seems like a reasonable approach is to: eat lots of organic vegetables, some organic fruit, limit meat intake, and perhaps take some vitamins.

It drives my wife crazy (because she is pro-vitamins) when I take specific vitamins just 2 or 3 times a week. I have a weekly pill dispenser and I randomly put in 2 or 3 each of vitamins E/D/C, and Coq10, calcium, magnesium, etc.

My thinking is that we evolved as hunter gatherers and we would not get the same nutrition every day, so why not mix it up a bit in modern times? I am fairly sure that I get what I need from my diet (I am a card-carrying food junkie; my food web site: http://cookingspace.com) but taking small random amounts of vitamins during the week maybe helps. Who knows. I think that it is as important how you eat (i.e., eat very slowly, appreciate the food) as what you eat.

driverdan2• 13 years ago

eat lots of organic vegetables, some organic fruit

"Organic" is an unscientific ideological term. It has absolutely nothing to do with the nutritional quality of food. Study after study has shown "organic" food to be nutritionally equivalent to scientifically farmed food, including quantities of pesticides found on them.

(Yes, citation needed but I don't have refs in front of me right now)

mark_l_watson2• 13 years ago

You should talk with my pet Parrot. If we give him non-organic food, he doesn't much like it. My wife and I agree: organic tastes better. I can not scientifically vouch for it being better for you, but I am very certain that it tastes better.

My Dad is a member of the National Academy of Science and he used to roll out the "no proof" argument. My argument, which he eventually accepted and he now eats organic:

1. it really does taste better

2. what can it hurt to eat locally grown organic food? Is it worth a small amount of extra money, just in case it is better to eat food not grown with petroleum fertilizer?

Anyway, make up your own mind.

baby• 13 years ago

For most people who eat correctly, taking Vitamins is more of a placebo than anything. I tried to start the discussion about it in scientific subreddits many times and got shut down. Vitamins are used way more than homeopathy and do works in many cases so it's hard for people to understand that it doesn't do anything, and might actually harm you if you take too much, if you're eating normally already (well in most cases).

6d0debc071• 13 years ago

This is a bit disingenuous.

Top title: 'Don’t Take Your Vitamins'

Base : 'As a result, consumers don’t know that taking _megavitamins_ [...]'

♫♫ One of these things is not like the others. ♫♫

If the advice is just don't mega-dose the things, well - duh. The things even have warnings to that effect:

http://i.imgur.com/5bS4gl2.jpg

Right there on the tube - 'do not exceed the recommended daily dose.'

I take that advice to be fairly uncontroversial. Lots of things are going to kill you if you take too much of them. Just don't be a bit silly and expose your body to really high levels of things that it'd never get anywhere near in nature without doing the research first.

I suspect that people don't think it's particularly risky because it's so concentrated - if they had to sit down and eat their way through packets of much less concentrated pills maybe they'd start to worry about loading their systems with so much stuff. :/ -shrug-

edem• 13 years ago

So should I take vitamins or not?

Don’t Take Your Vitamins

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