The one that got away

On my 40th birthday I had the opportunity to enjoy lunch with a wealthy member of the board of a major national health education initiative. He was smoking (this was down South) while pouring ketchup and mayonnaise on his cheeseburger and French fries. All the while encouraging me to come up with a dietary supplement that could prevent heart disease and cancer.

Like most people, he just wanted to be able to “buy” a natural cure so he could continue enjoying his high-risk life in the fast lane. Unfortunately, there is no such thing—despite the hype that’s been circulating recently about multivitamins and “anti-aging” supplements.

When the results of the long and prestigious Harvard Study on Physicians Health came out recently showing the benefits of a multivitamin to reduce cancer, the pharmaceutical company that makes it was quick to trumpet the results. (And I reported on them in the Dispatch (“What some doctors know—and do—about dietary supplements”).

Within a matter of hours, I’d already received an email from my local pharmacy about the convincing results of this study—just in case I missed it. And there were already full-page advertisements from supplement makers in that Sunday’s papers. But all of these outlets have been strangely silent about the lack of results found for heart disease in this same study.

But there are a number of explanations for this apparent contradiction.

Unfortunately, they used a standard, over-the-counter multivitamin supplement. A low-quality, mass-marketed, mass-produced product. (The kind made by companies that sink all their money into advertising instead of research.) Natural products industry standards have consistently and objectively ranked this particular supplement as among the very lowest in quality compared to the many other, higher-quality supplements available.

And, sadly, more high-quality products are often less well-known to the general public because the best supplement companies spend money on quality and research—not just marketing and advertising.

I have always pointed out the importance of using the right doses, in the right forms, and in the right combinations. A healthy diet contains many different vitamins and other constituents which work together naturally. And so should a healthy dietary supplement. (And multivitamin supplements should be free of iron which is a risk factor for both heart disease and cancer, and now glaucoma as well.) That said, the benefits of vitamins act slowly, cumulatively, over long periods. They are not a quick fix but have to be a long-term practice.

But these researchers claimed that supplement users are less likely to engage in other healthy behaviors (presumably because they think supplements are protecting them). However, they provided no evidence that this is the case. They presume that taking supplements has a “downside” because it somehow discourages other healthy behaviors. But in another study on supplements and health in women (which I told you about last week in the DispatchFishing without a license”), supplement users actually had healthier diets and other behaviors. 

Typically, supplement users in studies are always found to be healthier and to engage in healthier behaviors. You can’t have it both ways. And perhaps the authors of the Harvard Study on Physicians Health are more aware of that than they care to admit. Because they also point out that the physician participants with common risk factors for heart disease— such as high blood pressure, diabetes, or high cholesterol—were already being treated with powerful drugs. And that these drugs may “wash away” any of the more subtle effects of supplementation for heart disease. 

By contrast, there simply are no drugs to take to prevent cancer, so drugs weren’t a factor in the same study’s positive results on that condition.

Finally, we must consider the well-known issue of “competing risks” in epidemiologic studies. 

The researchers had already established that the physicians in this study who take supplements have lower rates of cancer. And the simple fact is, if a study participant does not die of cancer (the second-leading cause of death in the U.S.) first, then they are around longer to eventually die of heart disease (the leading cause of death in the U.S.).

After all, something has to get you in the end. But the evidence shows you can probably postpone that day of reckoning and experience healthier aging in the meantime with a healthy diet and the right dietary supplementation.