Blog | Wednesday, March 25, 2015

Isaac Newton's nutrient supplements

An article just out in The Atlantic is entitled, provocatively, “Vitamin B.S.“ This seems to share journalistic DNA with “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements“ from the Annals of Internal Medicine, and “Skip the Supplements“ from the New York Times.

This new piece in The Atlantic is a Q&A format with Catherine Price, a journalist and author of a book entitled Vitamania: Our Obsessive Quest for Nutritional Perfection. I have not read the book; in fact, this was the first I've heard of it. At least one review calls it measured, and it may well be. If so, it could be a very worthwhile read.

But the transcribed conversation in The Atlantic, starting with that headline, is rather the opposite of measured, taking the measure of prevailing sentiment, and apparently concluding that prevailing faith in nutrient supplements warranted some additional throttling. If enthusiasm for supplements is the action of concern here, this piece has opted to highlight the opposing reaction.

There are 2 potential problems with this. First, those most prone to have blind faith in the magical healing powers of nutrient supplements, a penchant I agree exists and I agree is a problem, are least likely to read an assault on that faith in The Atlantic, for rather the same reasons that evangelical Christians are unlikely to read even the most erudite treatise on the virtues of atheism. This begs the question: for whom, exactly, does the alarm bell in this piece toll?

It needn't toll at all for those who read, and believed, prior indictments of nutrient supplements. I suppose they might read this, too, if only to enjoy revisiting the opinion they already own.

We may surmise, then, that an article like this is mostly for someone other than the unshakably opposed or the unflappably faithful. If so, it suggests the readership is in the middle, those who may have certain convictions about supplements, but they are not fixed. The audience for such argument is an audience willing to hear argument, presumably.

That leads to the second problem here. That group seeking truth through an openness to new arguments—a large group, I hope—is unlikely ever to get there from here if every direction along the way is of the “abandon everything you thought you knew and start again“ variety.

That is the prevailing approach in our culture to the translation of research, expert opinion, or journalistic investigation into headlines, and it is a pernicious malady, propagating confusion and distrust at best, abject disgust at worst. This problem bedevils all discussion of diet, where we seem incapable of moving past the unending contestants in a beauty pageant to the beautiful truth of invisible consensus. It encumbers the dialogue about supplements, too, where the reality is more nuanced than panacea vs. B.S.

I have written at length about nutrient supplements before, and won't do so again here; those prior columns are at your disposal. Suffice to say that the evidence by no means rules out benefits of multivitamins, to say nothing of more targeted nutrient supplementation. In some cases, nutrients once thrown under the bus have been proven in time to have therapeutic effects as great or greater than the proprietary drugs that drove the bus. The exclusivities of a patented drug allow for profits vastly greater than those likely with any supplement, and that monetary divide propagates a divide in related research evidence. We are well advised to recall that absence of evidence does not equate to evidence of absence.

Magical thinking about nutrient supplements certainly exists, and needs to be discouraged. But it is rather discouraging if the only way we know to clear out such dirty bathwater is to let the baby go down the drain. The evidence in support of various nutrient supplements in various contexts is quite decisive. A one-answer-for-all approach does not work here, and hyperbolic headlines to not pave the way to understanding, or truth.

We may be thankful to Sir Isaac Newton for his brilliant insights about action and opposing reaction, the cosmic ping and pong of inertia, the native intemperance of physics. But we cannot possibly know what, if any, supplements Sir Isaac might himself take were he among us today. We do know that Newton's laws make a poor source of inspiration for headlines of science in the service of neither active fervor, nor reactive furor, but more temperate truths.

David L. Katz, MD, FACP, MPH, FACPM, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care. He is a board certified specialist in both Internal Medicine, and Preventive Medicine/Public Health, and Associate Professor (adjunct) in Public Health Practice at the Yale University School of Medicine. He is the Director and founder (1998) of Yale University's Prevention Research Center; Director and founder of the Integrative Medicine Center at Griffin Hospital (2000) in Derby, Conn.; founder and president of the non-profit Turn the Tide Foundation; and formerly the Director of Medical Studies in Public Health at the Yale School of Medicine for eight years. This post originally appeared on his blog at The Huffington Post.