Oh!! Here it is… this is it the vitamin aisle!
Ahhh
Vitamin A, B.. beeeeee,
<<super B complex, stress complex>>
Where in Vitamin C land, Prenatal, Multi plus omega, one a day for kids,
Fish oil land!! <<Shaking the pill>>
When you start reading the packets you think: do I need it, d?
Hi…. My name is Wendy Zukerman and you’re listening to Science Vs, the show where we pit facts against
<<Fish oil Gummy!>>
On today’s show… Vitamins and Supplements.
The Vitamin and Supplement Industry makes billions of dollars each year[1][2].... Telling us that we’ll live longer healthier lives by popping their pills... So senior producer Kaitlyn Sawrey and I checked out some of the claims at the pharmacy
Ooo enhances the immune system
Supports natural energy levels. Sounds like you need that. I def do.
Hey kaity look i found one for ya mum supports flexibility
Helps lubricates and protects joints that’s what your mum needs
But what is the best science on how helpful these products really are? That’s what we’re going to dive into today… by answering the following questions
And if our trip down the pharmacy aisle told us anything it’s that there’s a lot of vitamins and supplements… so we’re going to focus on some of the most popular -- Vitamin D, Calcium, Fish oils and multivitamins…
When it comes to Vitamins… there are lots of
<<Adult Gummy Fish Oils>> But then there’s Science
AHHHH
Science Vs Vitamins is coming up after the break.
BREAK:
BEAT 2: We need Vitamins!
Welcome back… Today we’re diving into the potential benefits of vitamins and supplements.
But first… a story from the high seas. You see… we need vitamins in our diet. And the story of how we came to know this was … pretty gross. Five hundred years ago[3] … sailors set out on long sea voyages … and people started to notice that wasn’t particularly good for them. They’d get this weird disease called scurvy where sailors would bleed uncontrollably from any exposed cut. In 1596 a British surgeon that saw a bunch of these poor sods wrote that:
MN: Their gums were rotten even to the very roots of their very teeth, and their cheeks hard and swollen . . . Moreover they were full of aches and pains, with many blewish and reddish staines or spots
WZ That’s pretty good. I think you went Scottish on a couple of words there though.”
MN It’s hard for me not to.
This by the way, is the Scottish born and bred Gimlet Producer, Matthew Nelson. But back to bleeding uncontrollably and Scurvy. No one knew why these poor sailors would get so sick… That was until the 18th Century when a Scottish physician named James Lind[4][5] realized what the problem was: these sailors weren’t getting enough citrus fruit in their diet[6]. And then he was like:
MN Eat an orange you wee bastard>>
WZ laughing
And it wasn’t until the 1920s and early 30s --before scientists singled out the magic ingredient in citrus fruit that protected sailors from scurvy: vitamin C[7]. Around that time, scientists were finding other vitamins in our diet were linked to diseases -- like Rickets, which can give children bowed legs, was linked to not having enough vitamin D[8]. Too little Vitamin A[9]? That could make you blind … These were some huge breakthroughs! Suddenly Vitamins were everywhere and they were curing people from horrendous diseases and people were so excited about them they started adding Vitamins to food [10], like flour and dairy products...
Vitamin D milk helps build strong bones and teeth and Ralph has decided it must be lots of milk which has given Linda such a bright smile 11 secs>>
Adding vitamins to foods made a huge difference…. Fortifying milk with vitamin D helped lead to an almost complete eradication of rickets in the US.[11] And in this great Vitamin Age companies quickly started turning vitamins into little pills and bottling them. And they were a hit! A magazine article from that time said that in 1937 Americans forked out almost 42 million dollars on vitamins from the drug store [12][13][14].
But the messaging around vitamins shifted and soon they were no longer just protecting you from something like scurvy or rickets… but they were helping you live a better brighter life…
Do you feel tired? Try Rybutol with Thiamin! https://www.youtube.com/watch?v=-nvgRtD7aOA
And over the next few decades, the message went even wider - there were vitamins for women, men and even kids…
https://www.youtube.com/watch?v=Q7S2_wDAyLA
<<10 million strong and growing -- Flintstones kids>>
And it wasn’t just companies that were excited about vitamins. Scientists were too. They wanted to know if taking vitamins and supplements could protect you from diseases that you might get down the line: like heart disease or dementia. And that’s where we are today. Professor Katherine Tucker, a nutritional epidemiologist at the University of Massachusetts in Lowell…(PRON LOWL)... says the science is ultimately asking.
<<KT: W hat are the amounts that are needed not just to prevent deficiency but to prevent chronic disease and keep us healthy and aging well?
WZ: And that seems like it's a much harder figure to get at-03
KT: Exactly. That’s where we are right now. it's much more complicated.
So on the back of your cereal box or your pill bottle, it might tell you how much of a vitamin you should take in every day. And what Katherine is saying is that number is trying to do more than just protect you from scurvy, it’s trying to keep you “healthy” and aging well. So, first question: How do scientists set that number? Because here’s the thing this isn’t a perfect science. And to understand how tricky it can be to know how much of every vitamin we need in order to be healthy: we’re going to look at the current debate over Vitamin D. So, maybe you’ve heard we’re experiencing a Pandemic of Vitamin D deficiency[15]
Important news about Vitamin D. A new CDC study, we’re not getting enough of it
You know that 100 million Americans have a vitamin D, 100 million! Even children
Vitamina D
The problem has become so serious
<Yeah… somebody’s gotta get you that Vitamin D Luda! .D>
See… Even Ludacris is worried about our vitamin D levels…
<<Girl, take this D, I don't want you gettin' sick tonight (sick tonight, sick tonight)>>
But are so many of really that low on Vitamin D? Well… to know that, you’d have to know how much VItamin D we need every day to be healthy -- And here’s the thing: scientists don’t agree[16]. [17] [18] It’s gotten kind of feisty.
There is a lot of animated discussion right now… a lot of disagreement right now…
And where does that disagreement come from? Well… it started with a crack team of nerds who were brought together by…. the Institute of Medicine[19] several years ago. And they had one purpose: destroy the world. No. To find out out much Vitamin D we need every day... and to do that they scoured through nearly a thousand studies[20] …These are studies where scientists track people’s vitamin D levels and see who gets what diseases.
And they whittle them down to the most important studies-01
And voila! They came up with a number that they reckoned keeps most people healthy. But some people say that number is too low, and we need more VItamin D.
Because here’s the thing there were a whole bunch of studies that that crack team of nerds didn’t use to set the Vitamin D magic number. These were studies claiming that Vitamin D could help prevent cancer[21], heart disease, autoimmune disorders, diabetes, and depression[22]… In fact, the only studies that made the cut were about bone health.[23][24] So the nerds set a recommendation for how much vitamin D you should have every day based on that. [25] [26]
And why did they sideline the others? They said that all those other diseases could not be “linked reliably or consistently” to taking Vitamin D[27]. But other scientists completely disagreed. And to Katherine it kinda all comes down to one thing.
And so, There's a lot of people that are willing to accept lower quality evidence in order to say yes you should be taking a lot of vitamin D and others that are saying we just don't know yet.
And this debate might seem really academic[28]… but every time you raise the bar on how much vitamin D you need, the more people who are seemingly healthy then become classified as “deficient”[29].[30][31]
Exactly… that’s where we are right now.
Conclusion: This back and forth over vitamin D supplements shows us how hard it is for scientists to agree on how much of a particular vitamin we need every day. And there's still a lot of debate over how many of us really are deficient in vitamin D... As for what we need that Vitamin for? We know it’s good for our bones, as for the other stuff -- reducing heart disease? or cancer? - we just don’t know yet.
But before you go popping Vitamin D pills… here’s something you should know: you can get your vitamin D for free from the sun.
When UV rays[32] hit your skin it collides with a chemical that then triggers the production of Vitamin D[33]. So going out in the sun is the most effective way to get this stuff[34]. And that means, no need to get Ludacris to fill your prescription…
<<LUDA!>>
You could take Katherine’s advice instead…
Go out for 10 to 20 minutes several times a week between the hours of 10 and 2 on a sunny day, and that should do it[35]
But, quick note… that advice might change depending on where you live in the world, what colour your skin is -- darker tones need more sun[36] -- and the time of year. Also, sunscreen blocks a lot of UV rays, which means you can’t produce a bunch of vitamin D[37]…. something to keep in mind.
After the break we’re going to take you through the top 3 vitamins and supplements taken in the United States. And ask… are they worth it? What are the risks? And will you regret not taking them?
BREAK
Welcome back. So we know if you’re deficient in vitamins bad things can happen to you -- you can get bowed legs and bleed uncontrollably.
MN Eat an orange you wee bastard!
But if you’re not in that extreme position… it can actually be really tricky to know exactly how much of each vitamin you need every day.
Still lots of people, pay lots of money, for lots of different vitamins and supplements: so what evidence is there that any of them, are they doing some good?
So, according to a recent survey of almosts 12,000 Americans the top three most popular vitamins and supplements are….
<Family Feud theme>
In the third spot… Fish Oils[38] <family feud bong>
Second place… Calcium <family feud bong>
and
The winner… is <family feud bong>
Multivitamins[39]
But do you need any of them?
Let’s start with number 3…. Fish Oils!
<<Shaking pills
This is fish oil land
Gummy fish oil!>>
And with Halloween just around the corner… Should you be handing gummy fish oil out to trick or treaters??
<<Trick or treat pharmacy>>
Ok generally speaking, fish oil is packed with Omega 3, which is a fatty acid. And our brain needs fatty acids to function properly[40][41][42][43][44] --
But our bodies can’t make Omega 3 fatty acids, which means you’ve got to eat them. It’s found in fish, flaxseed oil and walnuts. And scientists first realised the power of Omega 3s when they found that people who ate a lot of fish[45] --had a lower risk of heart disease[46], dementia[47] and Alzheimer’s[48]. So… some scientists… thought ah ha! If fish is so good… what if you extract the Omega 3 out of the fish… pop it in a capsule…Do you still get the benefits of eating the fish? And we’re gonna look at that today and we’re focusing on the claims about the brain.
Yeah… HI Wendy!! This is Simon Dyall. Dr Simon Dyall.
Simon is a neuroscientist at Bournemouth [BOURNE-MUTH] University in the UK. He has spent his career studying Omega 3… And says that once you take Omega 3 out of the fish… and stick it in a pill… it’s not so easy to see its benefits.
So it's very hard to sift through the literature and actually get a clear picture.
So what do we know? Let’s first look at people who are starting to go dotty. Say… the early signs of Alzheimer’s are already there? Can Omega 3 Help you? Probably not.
A big review paper published last year found[49]. “no convincing evidence” that Omega 3 could help people with mild or moderate Alzheimer’s[50] or dementia. And why is this? Well, it’s thought that by the time you’re showing symptoms… a lot of damage to your brain has already been done.
By the time you're showing these memory deficits it’s probably going to be far too late,
But… what if you take supplements before then… ? When your brain is doing just fine… could it prevent damage?
Well… Simon says …
Touch your toes…
No, Simon says a review paper on a bunch of studies[51] involving more than three thousand older people, who still had all their marbles, found that popping omega 3 had “no benefit” on their brain function[52].
But still Simon says this isn’t case closed. To really know if Omega 3 can prevent dementia… we’d need to follow a lot of healthy people for decades to see who gets dementia[53]. And then figure out if omega 3 -- or something else in their diet --made the difference. And this detective work is just really difficult.
SD studies in people are very messy. Studies in rodents, in tissue cultures, in petri dishes, they're much easier.
And that’s why Simon has done a bunch of studies in rats to see whether Omega 3 is really all that. In particular, Simon wanted to know just how much Omega 3 could do to fight nerve damage...
<<<SFX>>
So he damaged some rat nerves… He cut through one side of the rats spinal cord.
Yeah so the rats didn’t have a good time of it.
And then they injected Omega 3 into their blood. And a week later, he put them out and took a careful look at how they walked.
Rats are a sneaky little animal they’re very kind of good at hiding injuries, because the injured rat tends to get eaten.
Right! Simon really wanted to see if the rats that got the Omega 3 walked better than those given a placebo. And here’s the thing... they did[54].
This was really quite breathtaking. The wow moment
When Simon and a colleague[55] looked at their spinal cord injuries under the microscope… they found that the Omega 3 group had a much smaller injury, with less inflammation around the nerves.
Other studies in rodents have found that Omega 3 can potentially reduce inflammation in the brain[56], as well as neutralising a toxin[57]. On top of this: several studies in rats and mice found that animals given Omega 3 don’t show so many of the hallmarks of Alzheimer’s[58] as those that don’t get the stuff[59].
So that’s what we have right now … some really intriguing rodent studies… Is that enough evidence to stock the bathroom cabinet with Omega 3?
WZ: Do you take Omega 3 tablets
SD: I do actually take Omega 3, I take it to help preserve my brain!
So Simon seems to think it’s worth it. And that’s partly because he says the downsides of taking Omega 3, as far as we can tell, are really small…
<<The main is sues are tummy upsets. A little fishy aftertaste, a little burp-01>>
Now, if you go online… the claims for Omega 3 are bonkers… Science Vs senior producer Kaitlyn Sawrey asked Simon about it.
<<Just googling some of the claims, we've talked about cognitive benefits. Weight loss, cancer prevention. Is any of that true-03
In a word, no. Basically Omega 3s are sold as a universal panacea and that’s kind of frustrating. There’s a lot of good sound science behind omega 3’s but they’re sold as this cure all>>
Conclusion: We have some promising and consistent work showing that when rodents get Omega 3s it reduces nerve and brain damage … but if you’re not a rat getting your spine hacked into…. And as far as we can tell from studies on humans? There’s no strong evidence that it can prevent Alzheimer’s or dementia[60].
CALCIUM
Onto to the second most popular supplement in the United States <family feud brrrrring>
Calcium!
<<Family feud ding ding ding>>
According to that big survey of almost 12,000 Americans, around one in ten take Calcium[61]… And the one thing we’ve heard about calcium is it’s supposed to help protect us from osteoporosis… and keep our bones strong.
Them Bones and bones need calcium
But one scientist started asking questions about whether all this calcium supplementation was a good idea…Dr Mark Bolland is at the University of Auckland …. In New Zealand. See if you can tell us apart.
MB no one can ever tell australians and new zealanders apart.
WZ: it'll be a game while they’re learning science
MB: Yeah, you'll have to ask me lots of questions about six and sux. Or fush and chips
Ok… if you haven’t watched Flight of the Conchords… New Zealanders and Australians have very similar accents except for a couple of words… Like Fish and chips. I say fish and chips. Mark says
Fush and chips.
Did you hear it? Whatever. Let’s move on… Back to Calcium. Mark says that for years we’ve been thinking that if we popped calcium supplements… the calcium[62] would go into our bones to stop them from breaking…
Taking calcium supplements had become entrenched and all the guidelines recommended that people should take it
But in the 1990s[63] some large trials came out showing that calcium didn’t stop people’s bones from breaking. So Mark and his team decided to look at a whole bunch of studies… … more than 40 of them[64]. And? They found “evidence that calcium supplements prevent fractures is weak and inconsistent[65]” and later wrote their use in preventing osteoporosis should also be reconsidered. But, there is a bit of nuance here, Mark says that overall calcium supplements MIGHT prevent some fractures, but not many.[66]…
MB So by treating 100 people for five years you'd prevent 2 people having a fracture[67]
So you might think… well… that’s not too bad… that’s 2 people without broken bones out of a 100. But…then Mark found something else - something that made him want to nix calcium supplements from the medicine cabinet for good[68]. And this finding got the media excited.
Important news for any one who take calcium supplements
A new study found those who take these pills regularly at an increased risk of heart attacks…
This is a dangerous new development, what’s going on here?
His team’s initial study looked at more than 1400[69] older women and found that those given calcium supplements were more likely to die suddenly, have a stroke or heart attack than the women who got a placebo. Mark’s team then followed that up with a big review paper -- tracking thousands of older folks[70]. And he found the same thing[71]. BUT. While calcium supplements did increase the risk of getting a heart attack … not that many people in the studies actually got a heart attack[72].
<<MB yeah the risks of heart attack are small….>>
But… Mark says that the benefit of calcium supplements is tiny too… overall he just doesn’t think they’re worth taking.
Side note -- you might have heard that you should take calcium not by itself … but WITH Vitamin D to help your bone health… Mark looked into this. And he found that the combination didn’t help much either.
But -- of course -- not everyone agrees with Mark and his team. After Mark published his work… the National Osteoporosis Foundation, a leading body on bone health in the US, joined up with the American Society for Preventive Cardiology …. And they said that when it came it heart disease calcium supplements “should be considered safe.”[73] [74].
Are they just totally disregarding your work?
MB they're not totally disregarding it they just disagree.
WZ: How can you disagree when there is data?
MB: science is often about the art of science rather than there being an objective truth.
WZ: did you say the arse of science?
MB: no that's my thick new zealand accent for you. Art. A-R-T. The interpretation of results is an art, rather than a true science.
WZ so it is both the art and arse of science?
MB I didn't quite catch your australian accent there
WZ ahahahah
Ok… the thing that Mark is calling an art...is when, for example, you’re pulling together a bunch of studies to make strong conclusions about what supplements to take -- or not to take. It’s difficult. And reasonable scientists can disagree. Because you’re ultimately deciding what’s a good study or a bad study? Do you throw out the studies that didn’t consider people’s diets? Or how much exercise they do? Or do you toss out that study that accidentally signed up a bunch of amateur rodeo cowboys…?
<<Yeee harrr…. Broken bone SFX>>
What you let in and what is out can change your results. And just quickly… we’ve talked a lot about adults what the kiddos?
A review paper found studies “do not support” giving calcium supplements to healthy children[75].
<<WZ So your if you were going to explain this to your 7 year old he said daddy should i take calcium supplements. -04
MB: No they’d be a complete waste of time for you why do you ask?>>
Conclusion: While there is some debate here… as best we can tell calcium supplements -- with Vitamin D or not -- probably aren’t that helpful for keeping bones strong and preventing them from breaking. And meanwhile, they might increase your risk of getting a heart attack even if just by a little bit.
BEAT: MULTIVITAMINS
So finally… onto America’s favourite vitamin --- MULTIVITAMINS! <family feud big win sound>
Which, according to one survey, one third of Americans are popping[76]. People say you should take em, your kids should take em, you should feed em to your dog[77].
Lucky lost her luster? It might be a Vitamin deficiency
We know that eating a diet full of fruits and veggies packed all sorts of different nutrients can help us live longer and prevent heart diseases[78]. But what happens when you extract those essential vitamins into one big pill?? Well… Katherine - our nutritional epidemiologist has some good news for you…
<<KT Multivitamins will not hurt you!>>
A review paper published this year found that studies going on for 10 years find that multivitamins are safe to take[79]… But if you want more out of your pill than that … like, if you hope it’ll help you live a longer and healthier life? Well here the news isn’t so good.
<<KT There's been some big studies that show they didn't really have major effect[80]>>
One huge thumper of a study recruited 14,000 older men-- gave half of them multivitamins and half a placebo…. followed them for more than a decade. And after all that work??? Found no difference in rates of heart attacks and heart disease between the two groups[81].
And then when that research team looked at cancer? Men who took multivitamins had slightly reduced risk of cancer[82]… But the researchers said we shouldn’t get too excited[83] … Because other large studies have been really mixed[84][85].
Still… Katherine isn’t ready ready to piff out these vitamins just yet… because she says a few large studies done into multivitamins have been done in Doctors and they might already have good diets, better than your average Joe. So, for people who aren’t eating so well...
<<KT I think it doesn’t hurt to take a multivitamin for insurance… >>
Conclusion: As best we can tell multivitamins are safe to take, but there’s not good evidence that they can help you live longer either.
And just quickly… it’s starting to get colder in North America -- yay! Cold and flu season![86] Should you be popping Vitamin C and Zinc? Well. there is evidence that taking vitamin C[87][88] and zinc lozenges[89],[90] could help you get over your cold a little bit faster[91] but there’s not good evidence that it will keep you from getting sick in the first place[92]. A big review[93] didn’t recommend the average person pop vitamin C to stop them from getting a cold.
And then what about everything else? When it comes to Science Vs Vitamins… and Supplements … do they stack up??
Are we in a Vitamin D deficiency pandemic? Well… that all depends on how you define deficient, and scientists are battling through that right now. They’re even not sure exactly what Vitamin D supplements would be good for. The best evidence we have suggests that it might strengthen your bones. <<bing>>
What about Omega 3? If you’re a rat with a spinal cord injury get onto it! Stat! <<bing>> For the rest of us? Well as far as we can tell.. there’s no harm to taking them… even if the science at the moment doesn’t show that it really helps. <<bah-bow >>
As for Calcium…? There’s a debate going on. It might prevent a few broken bones <<bing>>> here and there… but you’ve got to weigh that against the potential but small risk of heart disease… <<bah-bow>>
And finally… Multivitamins… Well… again… the research is pretty underwhelming. <<bah-bow>>
But… the things is… we know that vitamins aren’t bull.
<Yee har>>
We know that we need to eat vitamins in our food to be healthy… That’s for sure. We’ve known that that for around a hundred years… But if your gums aren’t bleeding from scurvy, and your bones aren’t ferkukt from Rickett’s… Can vitamins and supplements help you live your healthiest longest life?
Well, it doesn’t look like they do much… But studying this stuff is really hard. And even all the research we have can’t tell us whether you --- you listening!! -- should be taking vitamins or not. And it’s this gap in the science… this nagging question of should I??? Maybe it will help??? Maybe I”ll regret not taking it? -- leaves room open for marketers to sell their wares to you, and not just you, your kid, your mum and even your dog.
That’s science vs vitamins.
And if you want to get more information about this episode -- you should subscribe our newsletter! We put in the transcript for each episode.. Including all our footnotes…! There’s also even more fun stuff in there. To sign up, head to Gimletmedia.com/newsletter.
CREDITS
This episode has been produced by me, Wendy Zukerman, Heather Rogers, and Shruti Ravindran. Production assistance from Rose Rimler. Our senior producer is Kaitlyn Sawrey. Edited by Blythe Terrell with help from Alex Blumberg. Fact checking by Michelle Harris. Sound design by Martin Peralta and Bobby Lord. Music written by Bobby Lord. An extra thanks to the Zukerman Family, Joseph Lavelle Wilson, Chris Giliberti, Jasmine Romero, Matthew Nelson, Stevie Lane, Dr Harri Hemilä, Stephanie from the New York State Library and Dr Rajapra-bhak-aran Rajarethinam
Next week we’re working on some new stories, so there won’t be a Science Vs episode, then we’ll come back with-- what’s killing the bees?
<<SE A world without bees is a world without blooming flowers and plants, we would still have food but we’d be eating gruel. KS the stakes are high. SE the stakes are very high. It literally is like Dorothy from the wizard of Oz going from Oz to Kansas.
I’m Wendy Zukerman, fact you next time.
[2] And roughly 37 bill North America; According to the report, global dietary supplements market valued at USD 132.8 billion in 2016 and is expected to reach USD 220.3 billion in 2022 and is anticipated to grow at a CAGR of 8.8% between 2017 and 2022. North America accounted for around 28% of the total market in 2016 and is projected to witness growth on account of increasing consumption of products with reduced calorie level and high nutritional content. [MATH: 28% of 132.8 billion is 37.1]
[3] This foul diet led to disease, as William Clowes, a naval surgeon, writing in 1596, recorded it: “Their gums were rotten even to the very roots of their very teeth, and their cheeks hard and swollen . . . Moreover they were full of aches and paines, with many blewish and reddish staines or spots, some broad and some small like flea-biting.”
[4] http://www.bbc.co.uk/history/historic_figures/lind_james.shtml
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC535077/
[6] Lind conducted one of the first controlled clinical trials in medical history on board the HMS Salisbury in 1747, concluding that citrus juice was a more effective treatment for scurvy than five other standard treatments, from seawater to laxatives.
[7] It would be 150 years before vitamin C would be isolated and characterized
[8] https://www.mayoclinic.org/diseases-conditions/rickets/symptoms-causes/syc-20351943
[9] In the 1930s, the isolation and chemical structure of - carotene and retinol were determined
[10] First came the iodization of salt in the 1920s (see pg 38)- this was one of the very first food fortification efforts ever- to help prevent goiter. At the time, goiter was endemic in the American Midwest, where natural sources of iodine were scarce. Followed by vitamin D to milk in the 30s, flour/bread in the 40s, calcium in the 80s.
[11] “The encouragement of sensible sun exposure and the fortification of milk with vitamin D resulted in almost complete eradication of the disease.”
[12] Some observers estimated that Americans spent $100,000,000 a year on dietary supplements in 1939; another estimate for this year placed the combined retail vitamin sales and sales to manufacturers in the food and poultry fields at $500,000,000.
[13] Between 1931 and 1939 vitamin sales in the US grew from about $12 million to about $87 million. By 1943 yearly sales had hit nearly $180 million.
[14] See p. 87.
[15] it has been estimated that 20–100% of U.S., Canadian, and European elderly men and women still living in the community are vitamin D deficient. Children and young and middle-aged adults are at equally high risk for vitamin D deficiency and insufficiency worldwide
[16]The composite literature is often confusing and has led to heated debates about the optimal concentrations of vitamin D and related guidelines for supplementation.
[17] The blood level of 25(OH)D that is defined as vitamin D deficiency remains somewhat controversial.
[18] a dramatic increase in physician-requested tests for patient vitamin D status in some countries;
The vitamin D deficiency pandemic and consequences for nonskeletal health: mechanisms of action.
[19] To carry out the request, the IOM established an ad hoc consensus committee of 14 scientists.
[20] Take into account nearly 1,000 published studies as well as testimony from scientists and stakeholders
[21] “Numerous of studies has demonstrated an association of vitamin D deficiency with increased risk of more than a dozen cancers, including colon, prostate, breast, and pancreas; autoimmune diseases, including both type 1 and type 2 diabetes, rheumatoid arthritis, Crohn's disease, and multiple sclerosis; infectious diseases; and cardiovascular disease.
[22] Low vitamin D concentration is associated with depression
[23] The indicator of bone health is selected as to form the basis of the DRIs for calcium and vitamin D for all life stage groups. With the exception of measures related to bone health, the potential indicators examined are currently not associated with evidence that could be judged either compelling or sufficient in terms of cause and effect, nor informative regarding dose–response relationships for the purposes of determining nutrient requirements. Cancer/neoplasms, cardiovascular disease and hypertension, diabetes and metabolic syndrome, falls and physical performance, immune functioning and autoimmune disorder, infections, neuropsychological functioning, and preeclampsia could not be causally linked reliably or consistently with relevant outcomes as a function of calcium or vitamin D intake.
[24] A 2014 review paper analysing whether Vitamin D could help with 137 different conditions found that while there was *some* evidence that Vitamin D could reduce your risk of bone disease, heart disease, depression and other stuff -- really convincing evidence “does not exist for any outcome”: “Highly convincing evidence of a clear role of vitamin D with highly significant results in both randomised and observational evidence does not exist for any outcome”.
[25] Benefit for most in the population is associated with serum 25OHD levels of approximately 50 nmol/L (20 ng/mL), making this level a reasonable estimate for a value akin to “coverage” for nearly all the population
The committee that wrote the report also reviewed hundreds of studies and reports on other possible health effects of vitamin D, such as protection against cancer, heart disease, autoimmune diseases, and diabetes. While these studies point to possibilities that warrant further investigation, they have yielded conflicting and mixed results and do not offer the evidence needed to confirm that vitamin D has these effects.
[26] "There is no evidence from meta-analyses of RCTs that vitamins D supplementation reduces the risk of cardio vascular disease or cancer"
[27] Page 299 of report:Cancer/neoplasms, cardiovascular disease and hypertension, diabetes and metabolic syndrome, falls and physical performance, immune functioning and autoimmune disorder, infections, neuropsychological functioning, and preeclampsia could not be causally linked reliably or consistently with relevant outcomes as a function of calcium or vitamin D intake.
[28] “ a considerable over-estimation of the levels of vitamin D deficiency in the North American population now exists”
[29] 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations ,30 nmol/L on average in the year,
[30] According to an alternate suggested definition of vitamin D deficiency (,50 nmol/ L), the prevalence was 40.4%.An analysis of more than 55000 Europeans found that just over one in ten would have a Vitamin D deficiency if we set the cut off at 30. Bump that up higher? And more than 1 in 3 become deficient. By then you’ve got a pandemic on your hands.
[31] Tim Spector wrote that “labelling people as deficient based on vague moveable thresholds that fail to account for large genetic influences… will cause many false positive results and potentially overtreatment”.
[32] “Food sources of Vitamin D are limited”. Also here: “The major source of vitamin D for children and adults is exposure to natural sunlight (3, 7, 35–37). Very few foods naturally contain or are fortified with vitamin D”
[33] VItamin D is not technically a vitamin, ie, it is not an essential dietary factor; rather, it is a prohormone produced photochemically in the skin from 7-dehydrocholesterol
[34] Vitamin D produced in the skin may last at least twice as long in the blood compared with ingested vitamin D
[35] This is says 5 to 10 minutes in the sun, around 3 times a week….
[36] People with a naturally dark skin tone have natural sun protection and require at least three to five times longer exposure to make the same amount of vitamin D as a person with a white skin tone
[37] Wearing a sunscreen with a sun protection factor of 30 reduces vitamin D synthesis in the skin by more than 95% (39).
https://www.scientificamerican.com/article/how-does-sunscreen-protec/
In simple terms, you can view an SPF 10 sunscreen as allowing 10 out of every 100 photons to reach the skin and an SPF 20 product as allowing only 5 out of every 100 photons to reach the skin.
[38] Multivitamin-mineral products were the most frequently reported type of supplement taken, followed by calcium and ω-3 or fish oil supplements.
[39] Multivitamin-mineral products were the most frequently reported type of supplement taken, followed by calcium and ω-3 or fish oil supplements.
[40] Statement ok’ed by SD
[41] Brain claim noticeably absent from Harvard write-up https://www.hsph.harvard.edu/nutritionsource/omega-3-fats/ but in LiveScience article says “Omega-3 concentrations are highest in the brain and nervous system. The fatty acids are necessary for optimal functioning of the neurons, protect cells, decrease cell death and improve nerve transmission”: https://www.livescience.com/38477-omega3-superstars.html
[42] Monkey study suggests deficiency causes vision problems: http://www.pnas.org/content/83/11/4021.short
[43] Review on mental illnesses suggests some connection with omega 3s but with caveats: http://www.mdpi.com/2072-6643/2/2/128/htm
[44] Depression review says “clear from literature that DHA is involved in a variety of processess in neural cells…” http://www.airitilibrary.com/Publication/alDetailedMesh?docid=09647058-200706-201306270012-201306270012-391-397
[45] That longitudinal observation studies on fish intake and DHA plasma concentrations in older healthy adults are mainly positive when it comes to cognitive health.
[46] Omega 3 PUFAs have been in the limelight since the astute observation by Bang in the 1970s that the Greenland Inuit had low mortality from coronary artery disease despite a diet that is rich in fat (Bang 1971). {{NOT JAPANESE}}
We found an inverse association between fish and omega-3 PUFA dietary intakes and cardiovascular mortality, especially for heart failure, suggesting a protective effect of fish intake on cardiovascular diseases.
[47] “The epidemiological evidence is consistent that eating fish protects from dementia, and these effects correlate with blood DHA levels.”- Email SD, need more. . Most longitudinal or case control
studies show an association between n-3 PUFA consumption or blood levels with lower risks of dementia or AD (reviewed in (Barberger-Gateau, Samieri, Feart, & Plourde, 2011; Morris, 2016; Yassine, Feng, et al., 2016)).
Yassine, et al: Higher dietary intake of the essential fatty acid docosahexaenoic (DHA) has been associated with better cognitive performance in several epidemiological studies. Animal and in vitro studies also indicate that DHA prevents amyloid deposition in the brain.
[49] “We found no convincing evidence for efficacy of omega-3 polyun-
saturated fatty acids (omega-3 PUFA ) supplements in the treat-
ment of mild to moderate Alzheimer’s disease (AD).” http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009002.pub3/epdf
[50] We found no convincing evidence for the efficacy of omega-3 PUFA supplements in the treatment of mild to moderate AD. This result was consistent for all outcomes relevant for people with dementia.
[51] This review included studies where healthy participants over the age of 60 years who were cognitively healthy at the start of the study were randomly assigned to receive extra omega-3 PUFA in their diet or a placebo (such as olive oil).
[52] No benefit of omega-3 PUFA supplementation on cognitive function in cognitively healthy older people.
[53] The findings on whether it helps with cardiovascular disease have been inconsistent. A big review said there wasn’t enough evidence to say that Omega 3 Supplements could help with depression . It can’t help your eyes -- or reduce your risk of macular degeneration.
[54] Resulted in significantly better locomotor performance for up to 6 weeks after injury.
[56] Omega-3 PUFAs have anti-oxidative and anti-inflammatory effects (Molfino 2014; Vedin 2012). Especially in the ageing brain, this characteristic may contribute to the protection of neurons and prevent cellular death.
[57] In the last 10 years, we accumulated data in support of the neuroprotective effects of n-3 PUFA dietary intake against toxicity induced by a neurotoxin, dietary intake against toxicity
induced by a neurotoxin, 1-methyl-4-phenyl-1,2,3,6- tetrahydropyridine (MPTP)
[58] Animals don’t develop the same illness as people, they just exhibit similar brain changes, depending on the type of model, so it is really that some of the hallmarks or characteristic brain damage seen with AD are improved by omega-3s (from Simon)
[62] More than 98 percent of all calcium in the body is found in the skeleton…
[64] Source: 50 reports, 44 cohort studies
[65] Source: Evidence that calcium supplements prevent fractures is weak and inconsistent.
[66] Calcium supplements did reduce the risk of total fracture, and vertebral fracture… Figures1-4 show that calcium supplements reduced the risk of total fracture (20 studies, n=58 573; relative risk 0.89, 95% confidence interval 0.81 to 0.96; P=0.004; fig 1⇓) and vertebral fracture (12 studies, n=48 967; 0.86, 0.74 to 1.00; P=0.04; fig 3⇓) but not hip fracture (13 studies, n=56 648; 0.95, 0.76 to 1.18; P=0.63; fig 2⇓) or forearm fracture (eight studies, n=51 775; 0.96, 0.85 to 1.09; P=0.54; fig 4⇓
[67] It would take 77 people for 5 years to prevent one fracture
[68] Mark’s study found the first evidence that calcium supplements may increase the risk of cardiovascular effects in the general population
[69] We reported the first evidence for adverse cardiovascular effects of calcium supplements in healthy older women. The Auckland Calcium study was a 5-year RCT of calcium monotherapy in 1471 healthy women who were postmenopausal Study is: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2222999/
[70] We invited the lead authors of 15 RCTs of calcium supplements in which the trial lasted for at least 1 year and had at least 100 participants to take part. Five provided patient-level data on cardiovascular events for 8151 participants with median follow up of 3.6 years, and 11 provided trial-level data for 11,921 participants with mean trial duration of 4 years. (This the study)
We included studies if they were randomised, double blind, placebo controlled trials; elemental calcium was administered at a dose of ≥500 mg/day; the participants’ mean age at baseline was more than 40 years; 100 or more participants were randomised; participants of either sex were studied; and the trial duration was more than one year
[71] The results of these meta-analyses showed that calcium supplements increased the risk of MI by 27–31%, and there were smaller statistically nonsignificant increases in the risk of stroke (range 12–20%), the composite cardiovascular endpoint (12–18%) and mortality (7–9%)
[72] RRs for incident cardiovascular events with calcium ranging from 1.21 to 1.49, and increased rates of MI and the composite cardiovascular event ranging from 1.43 to 1.67. Although the size of the study and small number of cardiovascular events meant that the results were not definitive, they did flag cardiovascular risk as an important safety concern. Also “in the calcium group, 31 women reported a MI compared with 14 in the placebo group (RR 2.24, 95% CI 1.20–4.17). For the composite cardiovascular endpoint of MI, stroke, or sudden death, the risk was also elevated with calcium (69 calcium group versus 42 placebo; RR 1.66, 95% CI 1.15–2.40).
[73] should be considered safe from a cardiovascular standpoint.
[74] “moderate” evidence that calcium with or without vitamin D intake from food or supplements has no relationship (beneficial or detrimental) to the risk of cardiovascular and cerebrovascular disease incidence, [DIRECT LINK TO THEIR POSITION: https://cdn.nof.org/wp-content/uploads/2016/10/NOF-ASPC-Position-Statement-Press-Release-FINAL-10-21-16_EMBARGO.pdf]
[75] Also here “The investigators concluded that, from a public health perspective, calcium supplementation of healthy children is unlikely to result in a clinically significant reduction in fracture risk.”
[79]“MVM are safe for long-term use (more than 10 y) Also another study found the same thing: Supplements did not confer any added advantage or harm relative to mortality risk.
[80]“ without a real benefit.” A 2006 review paper found there wasn’t enough evidence to show that a multivitamin could reduce your risk of chronic diseases or cancer…
Among this population of US male physicians, taking a daily multivitamin did not reduce major cardiovascular events, MI, stroke, and CVD mortality after more than a decade of treatment and follow-up.
While another paper analysing a whole bunch of studies found that when it came to multivitamins helping people stave off chronic disease most of them “reported no significant effect”.
[82] In this large-scale randomized trial of 14 641 middle-aged and older men, a daily multivitamin supplement significantly but modestly reduced the risk of total cancer during a mean of 11 years of treatment and follow-up.
[83] Caution must be applied in the interpretation of these analyses.
[84] Other observational studies suggest protective relationships of multivitamins with various cancers,28,29 no association,30,31 and possible harm.32
[85] Women's Health Initiative study provided convincing evidence that multivitamin use has little or no influence on the risk of common cancers, CVD, or total mortality in postmenopausal women. BUT, Nurses study finds “Long-term use of multivitamins may substantially reduce risk for colon cancer. This effect may be related to the folic acid contained in multivitamins.”
[86] http://sitn.hms.harvard.edu/flash/2014/the-reason-for-the-season-why-flu-strikes-in-winter/
[87] http://www.aafp.org/afp/2012/0715/p153.html#afp20120715p153-b20
[88] https://www.ncbi.nlm.nih.gov/pubmed/10796569
[89] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3394849/?_escaped_fragment_=po=35.0000
[90]Zinc may be a useful treatment for the common cold, started within 24 hours, for a time period of less than two weeks.” and “Given that there were only few and minor adverse effects in the three randomized trials, zinc acetate lozenges may be a useful treatment option for the common cold.”
[91] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136969/
[92] “Regular ingestion of vitamin C had no effect on common cold incidence in the ordinary population, based on 29 trial comparisons involving 11,306 participants. However, regular supplementation had a modest but consistent effect in reducing the duration of common cold symptoms, which is based on 31 study comparisons with 9745 common cold episodes. In five trials with 598 participants exposed to short periods of extreme physical stress (including marathon runners and skiers) vitamin C halved the common cold risk. The published trials have not reported adverse effects of vitamin C.” See also: https://www.ncbi.nlm.nih.gov/pubmed/10796569 and http://www.aafp.org/afp/2012/0715/p153.html#afp20120715p153-b20
[93] “The failure of vitamin C supplementation to reduce the incidence of colds in the general population indicates that routine vitamin C supplementation is not justified”
