"Vitamins linked with higher death risk in older women"

[Lamb]

I know this article is only yet another chapter in the "Supplements vs No Supplements" debate, which is likely to become endless, but I thought I'd post it here. Honestly, the high amounts of vitamins and other supplements some posters here report to take on a daily basis scare me. :scared: I don't mean to scare anyone back, but it never hurts to look at the flip side of things.


their findings suggest that supplements should only be used if there is a strong medically based cause for doing so because of the potential to cause harm.
"Based on existing evidence, we see little justification for the general and widespread use of dietary supplements," Dr Jaakko Mursu of the University of Eastern Finland and his research colleagues said.

http://www.bbc.co.uk/news/health-15238610

[Vanille_]

The only actual statistic given is a 2.4% increased death risk with regards to iron tablets. It says other vitamins saw an increase in death risk. But no data was given on what vitamins do what damage.

The article is extremely vague with nothing being cited. My impression is that the article's true purpose is to debunk myths that vitamins are completely risk free and that it's better to have more of a certain vitamin than not enough. However, a dramatic title linking vitamins to death (based on only one actual given statistic) makes for more viewers.

I don't actually know much about the pros and cons of vitamins. But an increased risk of death of 2.4% (which the article admits can't actually be solely attributed to the vitamin and not outside forces, like lifestyle and health) might seem worth it to people who are concerned what the very real consequences of NOT getting enough vitamins are.

I can't speak intelligently on the topic, I just wanted to give my impression of the article before people started panicking.

One of the most important things I've learned from school: Correlation does not equal causation.

[UP Lisa]

I think that Americans are being overdosed on some vitamins and minerals just from our food. If you eat cereal in the morning, you are getting a lot from that. Then you get more from what you eat later in the day. Vitamins and minerals are added to so many products that we eat. If they are water soluable, that might not be so bad, but what about the ones that aren't? If you eat Total cereal, for instance, you have already gotten what you need for the whole day.

[Tabitha]

Certainly iron, which they emphasise, can be toxic at not very much over the RDA.

On the other hand, I really don't want to live to be a very old lady with no relatives or friends and poor health ...

[KwaveT]

You just about have to be supplementing with iron to get an overdose on iron. Several things can inhibit iron absorption. Calcium is one one, grains is another, coffee also can. These sources inhibit nonheme iron which is iron from plant based sources. Any iron in say Total cereal as mentioned about will be inhibited from calcium fortification in cereal also. Why I don't understand why products are fortified with both iron and calcium since they are antagonistic to each other.

[ya-ya C]

everything needs to be in moderation. iron can be toxic at any age if overdosed (so is zink).

Now, my mom is 65 and about 7 years ago got into taking herbal suppliments from a Chinese company that works kind of like Avon (you can by just for yourself or sell to others and get points and levels and such). Among other things she takes spirulina that only just started appearing on Western market. Long story short she's 65, still working (she's a professor in college), taking care of my dad who is recovering from stroke, recently wrote a book... Plenty of energy, I would say. Oh, and since it's a hair forum I guess I can mention that one of the supplements she's taking for general well-being actually caused her grays to reduce enough for people to notice and start asking if she dyed her hair (she didn't turn completely black as she was in her youth, mind you, but still...) So, again, one should just know WHAT they are doing when taking supplements

[kitschy]

Iron usually isn't needed in women past menopause. I have never taken iron supplements even during pregnancy - and I've never been anemic.

I'm not saying that is the norm - usually women need iron because much is lost during menses, I'm just saying I've always gotten enough from my diet. Overdosing on Iron can be really detrimental to one's health.

[Fethenwen]

The only actual statistic given is a 2.4% increased death risk with regards to iron tablets. It says other vitamins saw an increase in death risk. But no data was given on what vitamins do what damage.

The article is extremely vague with nothing being cited. My impression is that the article's true purpose is to debunk myths that vitamins are completely risk free and that it's better to have more of a certain vitamin than not enough. However, a dramatic title linking vitamins to death (based on only one actual given statistic) makes for more viewers.

I don't actually know much about the pros and cons of vitamins. But an increased risk of death of 2.4% (which the article admits can't actually be solely attributed to the vitamin and not outside forces, like lifestyle and health) might seem worth it to people who are concerned what the very real consequences of NOT getting enough vitamins are.

I can't speak intelligently on the topic, I just wanted to give my impression of the article before people started panicking.

One of the most important things I've learned from school: Correlation does not equal causation.

I so agree with this.

[MsBubbles]

I have issues with this report, which I saw many places yesterday. I have yet to find a decent write-up about it where it's more specific. And if it's not really that specific, then it's worthless in my opinion.

I have so many questions about this study, for example: did the subjects in the study start taking supplements AFTER having a drastic illness? This is one of those attention-grabbing headlines that the media likes to harp on about, setting the cat amongst the pigeons, to get more reads.

Here's a quote from CBS news, which should calm down a lot of the hysteria right off the bat:

"The study, appearing in the The Archives of Internal Medicine, didn't look at a possible direct cause-and-effect dynamic. It was an observational study based on self-reported supplement use and, its authors say, a range of factors aside from the use of supplements could have impacted the outcome."

Well it's self-reported, for a start, which takes away a lot of clout, in my opinion.

I'm not going to let the sensational rags freak me out about this until I have come to my own conclusions about this study.

And yes, I know about the dangers of too much iron, and all the fat-soluble vitamins, and that biotin gives people zits.

[UP Lisa]

But that's the problem. The average person does not know what they are doing.


So, again, one should just know WHAT they are doing when taking supplements[/quote]

[embee]

My ex-DH was *way* into supplements. I followed along as he was "the boss" and had spent a good amount of time reading on the subject (whereas I had not).

Over time I have cut back and now take very few extra things, with those in low strengths. I'm also more careful with my diet, tending to eat real food as opposed to junk snacks and packaged meals/mixes. Happily I found that I was spending less on both supplements *and* food! :)

[CherrySilver]

But that's the problem. The average person does not know what they are doing.


So, again, one should just know WHAT they are doing when taking supplements


Absolutely -- most people don't want to be bothered to educate themselves and want to be spoon-fed information, even when it comes to their own health. Why? They're too lazy and want someone else to do the hard work/take responsibility for them. Sorry, but I don't buy it.

I take *tons* of supplements, some at high doses. But, then again, I've researched the heck out of it.

[littlenvy]

As much as I agree with the fact that supplements should be used as ... well supplement and NOT the main meal; I'm not quite sure how accurate this study may be.
My mother works for geriatric care and she sees families pumping loads of vitamins into their loved ones on daily basis in hopes of keeping them healthy. And you know what... strangly it works. Mom said most of them live much longer than anyone expects them too.
But then again, elderly do have a much lower absorbtion rate than younger people so maybe more vitamins is actually a normal amount for them. :shrug: At the same time their organs don't work as well as younger peoples so toxic minerals like iron or even selenium may not be cleared out or used by their system as quickly.

[growingpains]

Iron is kept behind the counter where I live and not freely available. To get it you need to have a recommendation (not prescription) from a doctor about what kind you need and how much. Pharmacists and doctors here advise you should never take iron unless you have had a blood test making it clear you need it. It's one of those rare ones that having too much of can be very bad.

A good 'ol multivitamin once per day is still a good bet, though, as I am told.

[UP Lisa]

Too much Vitamin A can cause hair loss.

[JuliaDancer]

Iron is kept behind the counter where I live and not freely available. To get it you need to have a recommendation (not prescription) from a doctor about what kind you need and how much. Pharmacists and doctors here advise you should never take iron unless you have had a blood test making it clear you need it. It's one of those rare ones that having too much of can be very bad.

A good 'ol multivitamin once per day is still a good bet, though, as I am told.

I only take iron pills in the few days before I donate blood. If not, I'm almost always turned away for having low blood iron. However, I'm not low enough that I'm anemic, I eat plenty of iron-rich foods, and I feel energetic, so I don't take iron pills on a regular basis.

[kitschy]

This information from the study:

Those taking multivitamins or supplements of iron, Vitamin B-6, folic acid, magnesium, zinc and copper had, on average, a 2.4 percent increased chance of death over the course of the research.

Iron had the highest associated risk.

But one supplement -- calcium -- appeared to reduce the risk of death.

[littlenvy]

This information from the study:

Those taking multivitamins or supplements of iron, Vitamin B-6, folic acid, magnesium, zinc and copper had, on average, a 2.4 percent increased chance of death over the course of the research.

Iron had the highest associated risk.

But one supplement -- calcium -- appeared to reduce the risk of death.
Which is funny because just a week ago my mother's doctor called her and told her to stop taking calcium. He just got a word that calcium suppliment has been linked to heart disease.

[KwaveT]

Which is funny because just a week ago my mother's doctor called her and told her to stop taking calcium. He just got a word that calcium suppliment has been linked to heart disease.

Calcium without Vitamin D can cause calcium to store in your body in the wrong places. Instead of going to the bones, it can go into your heart and calcify your heart.

[littlenvy]

Calcium without Vitamin D can cause calcium to store in your body in the wrong places. Instead of going to the bones, it can go into your heart and calcify your heart.
Yes. That's what he told her. And because she is taking some medication that decrease her D (I think its some cholesterol lowering meds) they can never be sure she has enough D to process all the supplimented calcium. So now he put her on this high fiber/natural calcium diet. Poor thing. Its mostly rabbit food for her now.

[embee]

I read about that calcium/heart thing some months ago. Made me think. I then cut my calcium supplement by half and - amazingly - feel remarkably better when I exercise. Imagination? Maybe. But I eat dairy foods so probably get a good bit of calcium that way anyway. Truth: I'd rather get it through diet, thank you very much.

[MsBubbles]

The Paleo-ists say that we can get all the calcium we need from plants, and that the usually-encouraged dairy products are so acidic they actually impair calcium uptake. I'm inclined to believe this. But until I can give up dairy, I'll be taking supplements with D.

[KwaveT]

Yes. That's what he told her. And because she is taking some medication that decrease her D (I think its some cholesterol lowering meds) they can never be sure she has enough D to process all the supplimented calcium. So now he put her on this high fiber/natural calcium diet. Poor thing. Its mostly rabbit food for her now.

My seizure medication does the same thing. That is why I take a 2000IU Vitamin D supplement in addition to Vitamin D that is in my 500 mg calcium chew.

[Faepirate]

This may be a really stupid question but... what exactly is meant by "increased chance of death"? Like, sudden death? Or... what?


I don't take any vitamins. Except omega 3, occasionally, because I don't feel ok with consuming vast amounts of fish contaminated with goodness knows what. I try to eat well though.

[MsBubbles]

This may be a really stupid question but... what exactly is meant by "increased chance of death"?.

Exactly. :rolleyes:

[pelicano]

This may be a really stupid question but... what exactly is meant by "increased chance of death"? Like, sudden death? Or... what?

Not a stupid question at all. The whole thing makes no sense!

[Chamomile betty]

My doctor knows what I take and he's fine with it.
Vitaminshoppe Multi
Biotin
Flaxseed Oil
Garlic (every other day)
Plus my two blood presure meds and my anti-anxity med.

I need iron in my multi because I rarely eat meat and my period is heavy at times. Sometimes a vitamin is needed to due to a decrease in vitamins due to sickness or other medications. Just be safe is what I suggest. See if there are any interactions.

[teal]

I wonder whether these increased odds are because the demographic group being surveyed are taking supplements as a replacement for proper diet and exercise. I mean, I take vitamins to fill the gaps when I fall off the eating-healthy bandwagon, not as a be-all, end-all. (Edit: I mean I take them all the time, not just when I'm eating like crap.) Some people truly think if they take a multivitamin then they're free to plant their duff on the couch and eat crap day in, day out for the foreseeable future. Sedentary lifestyles and poor diet could certainly hasten death...

[UP Lisa]

Do you feel that your blood pressure and enxiety meds have caused any hair loss?



My doctor knows what I take and he's fine with it.
Vitaminshoppe Multi
Biotin
Flaxseed Oil
Garlic (every other day)
Plus my two blood presure meds and my anti-anxity med.

I need iron in my multi because I rarely eat meat and my period is heavy at times. Sometimes a vitamin is needed to due to a decrease in vitamins due to sickness or other medications. Just be safe is what I suggest. See if there are any interactions.

[Ashenputtel]

I've read that too. I just started to take vitamin since I have a bad cold.

Honestly at my age and weight I don't think there are any risks.

However, when taking a multi please be careful about taking and extra pill of vitamin A,D,E,K. They are liposoluble.

[PinkyCat]

I wonder whether these increased odds are because the demographic group being surveyed are taking supplements as a replacement for proper diet and exercise. I mean, I take vitamins to fill the gaps when I fall off the eating-healthy bandwagon, not as a be-all, end-all. (Edit: I mean I take them all the time, not just when I'm eating like crap.) Some people truly think if they take a multivitamin then they're free to plant their duff on the couch and eat crap day in, day out for the foreseeable future. Sedentary lifestyles and poor diet could certainly hasten death...

This.
I understand how easy it is to hit a drive thru window everyday - but man is there some bad bad stuff in that food. I think that must be a big factor.

[swords & roses]

I thoroughly agree that this study is alarminly vague. Which causes of death were increased? What other factors could have led to these increases? How were the vitamins & supplements taken?

That last one can have a BIG effect on what your body is able to do with what you put in it. For instance, water soluble vitamins can only be absorbed into your bloodstream if taken with water. Fat soluble vitamins need to be taken with fats in order to be absorbed. Some vitamins & minerals can only make it into your bloodstream if taken on an empty stomach. Others need to be taken with food. If the vitamin isn't absorbed into your bloodstream, your body can't use it. The same concept applies to the vitamins found in real food, too. What happens to the unabsorbed vitamins varies as well. Some are excreted through urination. (Excess vitamin C does this) Some accumulate in various areas of the body, such as in fat cells, and could potentially cause harm if too much accumulates.

The main take-home message is that it is very important to research anything you consume, from vitamins and supplements to food itself. It's also very important to consult with your medical doctor, nutritionist, chiropractor, pharmacist, and anyone else you trust with your health & nutrition about which vitamins & supplements would be beneficial for you, how much you should take of each, and in what manner you should take them. Every person is different, and has different nutritional requirements.

[Panth]

Come on guys... please, if we're going to rubbish the article, can we at least rubbish the original scientific report, rather than complaining that things are too vague, yet only reading the little news reports...

A very quick google for The Archives of Internal Medicine brings up the actual article being reported on. It's here (http://archinte.ama-assn.org/cgi/content/short/171/18/1625).

Now, most people can only access the abstract. However, even from that you can get a reasonable amount of detail about the study, e.g. what age were the 'older' women, how long did the study run for, etc.


This may be a really stupid question but... what exactly is meant by "increased chance of death"? Like, sudden death? Or... what?

"Increased chance of death" means that, in the time period the study ran for, a greater percentage of people in the "vitamin-whatever taking group" died than did in the "control, taking no vitamins" group. So, say they study these women for 20 years and they were 60 when the study started, well, a certain percentage would be expected to die between the ages of 60 and 80 for every and any sort of reason. They simply see if this death rate is higher in the vitamin-taking group than in the control.

If it was increased chance of sudden death then it would say "increased chance of sudden death". If it was an increased risk of death from heart attack again, it would say that precisely. However, this is just an increased risk of death in general.

EDIT:: If anyone does want the article for personal reading use only, I can email you a copy.

[MsBubbles]

Come on guys... please, if we're going to rubbish the article, can we at least rubbish the original scientific report, rather than complaining that things are too vague, yet only reading the little news reports...


Nice verbification of the noun "rubbish". :-D

Well, this is a long hair board, and not studentdoctor.net, so we're less likely to launch straight into logical discussions void of emotion. Thank you for your kind offer to send the whole report. I would love to read it! I was having a hard time finding the full report.

[dulce]

There may be some validity to this but you need to take it with a grain of salt,I recently read in Prevention magazine about some studies citing benefits to calcium and multi vitamin intake.So I think it's a matter of balance,too much or too little gets you in trouble.

[Yame]

This may be a really stupid question but... what exactly is meant by "increased chance of death"? Like, sudden death? .

ROFL! Not stupid at all! I wondered the same thing, after all, we all have the same "chance of death" no matter what we do. It's 100%, lol...

[Panth]

ROFL! Not stupid at all! I wondered the same thing, after all, we all have the same "chance of death" no matter what we do. It's 100%, lol...

It's chance of death in a given period of time (i.e. the duration of the study). Of course, everyone has a 100% chance of death between ages 0 and 150. However, the chance of death between the ages of 60 and 80 is not 100%. By comparing the chance of death in that specific window of time in the control group and the group taking the vitamin you can determine if chance of death was increased.

[Panth]

Nice verbification of the noun "rubbish". :-D

Well, this is a long hair board, and not studentdoctor.net, so we're less likely to launch straight into logical discussions void of emotion. Thank you for your kind offer to send the whole report. I would love to read it! I was having a hard time finding the full report.

*shrug* Well, it was more people criticising the study design when the study itself was not wrong/omitted, just the news report - e.g. swords & roses' comment saying that the study was vague. You can't really complain that the study is vague and without crucial details if you only read someone else's short paraphrasing of it...

If you do want the report, PM me your email address and I'll send it along.

[Jing]

I agree with Panth - it doesn't do to wave off the results of a study because the news article relating them to the general public is being vague. As a side note, to me supplements like fish oil always seemed to make more sense than vitamin pills. Our digestive systems aren't "designed" for pills; they're "designed" for food.

[swords & roses]

Oh gosh, my appologies! I didn't mean to come off that way! *Must proofread things before posting them!* I'm actually up to my eyeballs reviewing other research articles atm, so I think I got my wires crossed somewhere. What I *meant* to say was that the report from the BBC was a bit vague, which tends to happen when paraphrasing, no matter what the original source. My deepest appologies to anyone who might've been offended by my previous post.

Panth, I'd love to see the research article in full! I currently can't PM due to newbie status, but that should change soon. Once I have access to PM'g priviledges, I'll send you my email addy. Thanks for offering to send that out to us!

Now that I realize I've made a glorious fool of myself, I'm going to go hide in a corner now until I've found time for a nap so I can think straight again! :o

[Panth]

Oh gosh, my appologies! I didn't mean to come off that way! *Must proofread things before posting them!* I'm actually up to my eyeballs reviewing other research articles atm, so I think I got my wires crossed somewhere. What I *meant* to say was that the report from the BBC was a bit vague, which tends to happen when paraphrasing, no matter what the original source. My deepest appologies to anyone who might've been offended by my previous post.

Panth, I'd love to see the research article in full! I currently can't PM due to newbie status, but that should change soon. Once I have access to PM'g priviledges, I'll send you my email addy. Thanks for offering to send that out to us!

Now that I realize I've made a glorious fool of myself, I'm going to go hide in a corner now until I've found time for a nap so I can think straight again! :o

Oh, goodness, please don't feel bad!

I wasn't being critical of *you*, rather simply the way you phrased that particular thing. Also, I wasn't trying to single you out - you were just the last comment that illustrated what I was talking about.

I can certainly understand being overwhelmed with journal articles and the like and having a brain-fritz. I'm currently kinda like that at the moment - start of term and lots to read! :blossom:

[swords & roses]

Oh, goodness, please don't feel bad!

I wasn't being critical of *you*, rather simply the way you phrased that particular thing. Also, I wasn't trying to single you out - you were just the last comment that illustrated what I was talking about.

I can certainly understand being overwhelmed with journal articles and the like and having a brain-fritz. I'm currently kinda like that at the moment - start of term and lots to read! :blossom:

Fair enough! ;) I'm at the end of grad school. It's chaos! :D Exciting, but chaos! My brain hurts! Lol! :flowers:

[heynormy]

I have a question, and someone please correct me if I'm wrong, but was this research based solely around the consumption of iron supplements in older women?

[Panth]

Fair enough! ;) I'm at the end of grad school. It's chaos! :D Exciting, but chaos! My brain hurts! Lol! :flowers:

Ah, I'm at the beginning of grad school. *grin* Good luck with managing the chaos!

[ZenGwen]

Correlation is not causation. I've been seeing this report all over the place and all I can do is slap my forehead at the amount of people taking it seriously.

I think it's like the diet soda effect. A lot of people, when they have a diet soda instead of a normal soda, think they can afford to give themselves a treat - perhaps a bar of chocolate, for example, which will contain more calories and fat than the original soda. Before long they're eating all kinds of crap and excusing it with diet soda, skim milk, or eating a piece of fruit or a vegetable to "make up for" treats.

I see it in sports a lot too. I go to the gym at least three times a week, and swordplay at least once a week. I see people at the gym guzzling all kinds of nutrition drinks and supplements and then doing crappy workouts - like 20 minutes of cardio, maybe a half-hearted attempt at some light weights on the machines - and thinking the supplements will make up for the lack of effort. Or the chubby geeks at swordplay who think that because they're hefting a bastard sword around for a couple hours a week, and sweating heavily under all the fencing kit, they're doing enough exercise. (I don't wish to sound mean - they're my friends, I love them, I used to be like that too, but it's really not enough. I am also a geek, but a fit geek!)

Same thing with vitamins. Take a multivitamin in the morning, think you've done something good, let your guard down about everything else you eat that day.

Sure, I take multivitamins, and drink protein shakes after workouts, and use skimmed milk. But I also don't drink any soda, I lift weights, I run regularly, I very rarely have sweets or high-sugar fruit juice, I get 6-8 servings of fruit and vegetables a day, lots of wholegrain carbs... people just need to do their research and actually take responsibility for their health, rather than relying on the idea that if they're doing some things which are healthy, their lifestyle is suddenly great for them.

Anyway. Yes. That's what I think is going on here. (And other people have mentioned it too, although I haven't taken the time to read through all the responses.) Taking a multivitamin will not make you keel over, using it as an excuse to live in an unhealthy way will.

[CherrySilver]

Correlation is not causation. I've been seeing this report all over the place and all I can do is slap my forehead at the amount of people taking it seriously.


No kidding. You'd be surprised at the number of people out there who are not capable of critical thinking. They believe what they want to believe. But, would they ever take the time to go find something out themselves? Noooooo. Unless Dr. Oz or some "authoritarian figure" tells something is good or bad, they won't buy it.

[Panth]

I have a question, and someone please correct me if I'm wrong, but was this research based solely around the consumption of iron supplements in older women?

Nope.

They took 38772 women. The average age at the start of the study was 61.6 years. They then studied them between the start of the study (1986) and the end (2008 ). In 1983, 1997 and 2004 they asked the women to report fill out a standard survey (this particular survey is commonly used in this field of research). Some of the questions included vitamin usage. Between 1986 and 2008 they kept a record of every death.

They then divided the women up by which vitamins they'd taken (none, a multivitamin, vitamin A, beta-carotene, vitamin B6, folic acid, vitamin B complex, vitamin C, vitamin D, vitamin E, selenium, iron, magnesium, zinc, copper and calcium) and used statistics to determine whether taking a particular vitamin increased the likelihood of death during that timespan.

Additionally, there were some shorter-term studies of the same sort that looked only at calcium, iron or no supplements for 4, 6 or 10 years.

For each vitamin, the change in absolute risk of death (i.e. the increase/decrease in death risk as compared to the control, non-vitamin-taking women) was as follows:
- a multivitamin - 2.4% greater chance of death
- vitamin B6 - 4.1% greater chance of death
- folic acid - 5.9% greater chance of death
- iron - 3.9% greater chance of death
- magnesium - 3.6% greater chance of death
- zinc - 3.0% greater chance of death
- copper - 18.0% greater chance of death
- calcium - 3.8% less chance of death
- the rest - no significant change in chance of death

These results were replicated in the shorter trials.

The total baseline death rate for the duration of the study was 57.0% (that's my calculation, based on the no. at the start of the study and the no. quoted as being alive at the end). However, during their calculations, they excluded deaths from injury, accident or suicide as they considered these were highly unlikely to be related to supplement use.

As for confounding variables, the questionnaire also asked about age, height, educational level, place of residence (farm, rural area other than a farm, or city), diabetes, high blood pressure, weight, waist & hip circumferences, hormone replacement therapy, physical activity, and smoking. These were then taken into account when doing the statistics.

For those theorising that the issue is that supplement use was used to make up for a healthy lifestyle, note they say: "supplement users had a lower prevalence of diabetes mellitus, high blood pressure, and smoking status; a lower BMI and waist to hip ratio" ... "supplement users were more likely to have lower intake of energy, total fat, and monounsaturated fatty acids, saturated fatty acids and to have higher intake of protein, carbohydrates, polyunsaturated fatty acids, alcohol, whole grain products, fruits, and vegetables." Note, of course, that these variables were controlled for in the analyses.

The supplement they are most concerned about is iron, which they say was "strongly and dose dependently associated with increased total mortality risk" and "the association was consistent across shorter intervals, strengthened with multiple use reports and with increasing age at reported use".

They acknowledge the shortcomings of their study - e.g. that subjects might have changed their supplement routine if they were diagnosed with a disease during the study, or that some subjects genuinely needed their supplements due to a particular disease. They also emphasise that the study is only giving evidence about white women of age approx. 60-80 and the findings can't be extrapolated onto other groups. They say "Based on existing evidence,
we see little justification for the general and widespread use of dietary supplements. We recommend that they be used with strong medically based cause, such as symptomatic nutrient deficiency disease."

What you want to take from that is up to you. It seems to be a reasonably good study (as much as a non-specialist can tell, anyway) but it is only one study and they acknowledge that some of their results conflict with those of other studies.

[MsBubbles]

Thank you for the breakdown, Panth. That was extremely helpful.

Here's something I got via pseudo-junkmail, which I find interesting regarding that study:

http://drhyman.com/why-you-should-not-stop-taking-your-vitamins-7781/?utm_source=Publicaster&utm_medium=email&utm_campaign=drhyman%20newsletter%20issue%20#38&utm_content=Get+the+story

[Panth]

Thank you for the breakdown, Panth. That was extremely helpful.

Here's something I got via pseudo-junkmail, which I find interesting regarding that study:

http://drhyman.com/why-you-should-not-stop-taking-your-vitamins-7781/?utm_source=Publicaster&utm_medium=email&utm_campaign=drhyman%20newsletter%20issue%20#38&utm_content=Get+the+story

Hmm... to give another little breakdown, I personally think that report you link to is (partially) flawed. Basically, he is correct in saying that the study only showed correlation, that the population group studied was quite limited (i.e. only white, menopausal/post-menopausal American women) and that as an epidemiological observation-based study that it cannot be used to influence medical advice or treatments without further research.

However, he does also make some mistakes and mis-judgements in his argument.

1) The paragraph under "How Vitamins Save Money and Save Lives"

- he says the original study flies in the face of previous research - now, this alone is not an indicator that the study is wrong! (Particularly since the two big studies he mentions were literature reviews - i.e. potentially have an even more tenuous link to the real situation than an observation, particularly since they pool multiple groups of data that then have to be fudged to be compared, since they will not have been studying the same population group or using precisely the same measures.)

- for the telomere study, well, again, there's a problem with that - measuring telomeres is an indirect measure of longevity and as such is to be taken with a (very small, but still present) pinch of salt

- for the controlled studies - this is the crucial part and the bit I think he's missing - the original study (unlike these controlled ones) looked at all supplement taking, not just doctor-prescribed vitamin taking, not just taking vitamins for a specific illness/condition - it is entirely likely that what is beneficial to an ill person is not beneficial in the entire population (indeed, IMO that could well be what the original study is actually telling us)

2) Under the heading "Why Most Vitamin Studies are Flawed"

- this doesn't really count for the original study as (as I said before) it was looking at total supplement consumption, including non-prescribed ones. Most individuals are not going to know about complex vitamin interactions and therefore could well take combinations that won't work - thus, the study reflects reality (as it must, as it was observational - i.e. did not tell anyone to change what they did, just measured certain parameters whilst they carried on as normal)

- however, this argument could stand for the previous studies he mentions ... and thus would weaken his arguments above that the original study must be wrong since it goes against previous ones

3) Under the heading "Obesity is linked to Malnutrition"

- this does indeed seem to be the case

- however, among other things the original study controlled for weight, and also for waist & hip circumferences - i.e. the two best (easy) parameters for obesity that we have

- in any case, if an obese person is malnourished they should go to a doctor, get tests for vitamin levels taken and then supplement based on known deficiencies - not, as in the original study, just take random supplements (like the individuals studied)

4) Under the heading "Flaws in the "Vitamins Kill You" Study:

1. This is a patent falsity. If you note my comment above, hormone replacement therapy *was* one of the questions in the survey and *was* taken into account.

2. This is true ... but iron was not *given* to the post-menopausal women in the study - they took it themselves regardless of the fact they were being studied. It is an observational study. So this cannot be a criticism of the study, rather it says again that people should not just randomly take supplements but should consult a doctor.

3. Patient background was not completely ignored (as I said in my previous comment, many parameters of health, e.g. weight, were monitored by survey). As for the whole 'people could have started/stopped taking supplements due to developing an illness', well - that is a valid criticism, but it is one that the authors made of their own study. It is a limitation of the original study but does not make the entire thing invalid, rather it calls for further research.

4. No, the population was not representative. The population rarely is in studies, even in the Phase I, II and III clinical trials that are needed to get a new drug licensed. Basically, it's 2 things - there are more white people in the rich countries that fund the majority of studies; and well-off white people are more likely to volunteer for studies (education probably influences this). So, yes, this is a valid criticism ... but if you discounted all studies that had this problem you'd never have another drug on the market - so, it's something that has to be worked around.

5. True, but really ... I personally think that is rather out of the scope of the original study. It's point was not to provide the be all and end all of all information about the subject -no study could ever do that, particularly not on its own- it was rather, to provide an initial investigation that could then be followed up in more detail.

6. Like no. 5 but so much more so. A study, being what it is, looks at a tightly proscribed part of life. It has to, otherwise the variables may be great enough to obscure the data (unless impossibly enormous samples are taken) and/or the amount of data generated would be completely unmanageable and impossible to analyse, drawn conclusions from or report on. Incorrect medication prescription and hospital deaths have nothing whatsoever to do with vitamins. Nothing. It's just a great big red herring. Yes, people may die from that. Maybe you could argue it's more important to study that. So what? Other people are studying that. That's not what the original study was about. It was about people taking supplements. *gah*

So, erm, yeah. So, basically, a few criticisms are valid. Most are complete red herrings.

....aaaand then there's the great big glaring fact that the authors of the original study had no conflictions of interest, yet Dr. Mark Hyman sells vitamins for a living. Suspicious, no?