Saturday, March 25, 2006

Dietary Supplements Attacked by the Media

by William Faloon - The Life Extension Foundation

The media has launched an assault against healthy lifestyles and some popular dietary supplements. The public has been thrust into a state of confusion by these frenzied media reports that contradict long-established scientific principles.
I am impressed by how quickly Life Extension members picked up on the errors contained in the studies used to ridicule those who practice healthy living.
The outrage over these biased reports was not limited to Life Extension members. The front page of the Wall Street Journal carried a scathing report about how the Federal Government issued misleading press releases that gave the media the green light to discredit alternative approaches to disease treatment. According to the Wall Street Journal:
“Design problems in all the trials means the results don’t really answer the questions they were supposed to address. And a flawed communications effort led to widespread misinterpretation of the results by the news media and the public.” 1
What you are about to read might at first seem unbelievable. Please remember, however, that the studies we describe were conducted by mainstream doctors who know virtually nothing about natural ways to prevent and treat disease.
As you will also find out, many of the doctors who designed and authored these flawed studies received financial compensation from the very pharmaceutical companies that stood to gain the most by deriding low-cost natural approaches to disease prevention.
Media says: Eat all the fat you want.
Does eating a low-fat diet reduce the risk of contracting common diseases? The media answered this question by boldly proclaiming that there is no benefit to women eating a low fat diet. According a lead article in the Washington Post:
“Low-fat diets do not protect women against heart attacks, strokes, breast cancer or colon cancer.” 2
The study that this headline story was based on, however, failed to differentiate between health-promoting fats (such as monounsaturated and omega-3 fats) and lethal trans fats. 3-5 It was long ago established that over-consumption of trans fats is related to atherosclerosis, cancer, and chronic inflammation. 6-12 Furthermore, there was no attempt to measure the balance of omega-3 and omega-6 fatty acids. Most Western diets contain an abundance of omega-6 fatty acids (e.g., corn, safflower oils) and completely inadequate levels of omega-3 fatty acids (such as fish oil, flaxseed, and walnut oils).
The “excuse” some researchers gave when confronted with these flaws was that when the low-fat studies were designed, doctors did not know the difference between friendly and deadly fats. The facts are that when these studies were designed, there was an abundance of published scientific data to show that friendly fats like olive oil 13-35, flax oil 36-43, and fish oil 44-57 conferred life-saving benefits while trans fats were proven killers.
Researchers also were unable to rigorously monitor whether or not the participants actually followed low-fat diets. Food-intake questionnaires were used, which are notoriously unreliable indicators of food intake.
In what is perhaps the most outrageous defect in these studies, only 1 in 7 women actually achieved the low-fat diet threshold! Specifically, only 14.4% of the “low-fat” group really followed a low-fat diet. Furthermore, the average reduction in total fat intake in the “low-fat group” was only 8.2% (with just a 2.9% decrease in saturated fat intake). Assuming that this paltry 8.2% figure is accurate (i.e., that the food questionnaires were completely accurate), this number does not come close to the percentage of fat-calorie reduction other studies have shown is needed to reduce disease risk.
These flaws rendered this multimillion-dollar low-fat diet study worthless. This did not stop major newspapers, however, from featuring articles on their front pages stating that reduced-fat diets provide no health benefits.
Media says: calcium does not protect bones
One of the most controversial media stories dealt with a study that supposedly showed that women who took calcium and vitamin D supplements did not obtain any protection against hip fracture. 58
We at Life Extension initially thought this negative finding was because the active group was not given magnesium, zinc, manganese, and other nutrients that are essential to maintaining optimal bone density.
When we got our hands on the study itself, we were startled to find that the women in the study who actually took their calcium and vitamin D supplements suffered 29% fewer hip fractures. 58 This was contrary to what the headlines said. It turned out that the media believed the government’s negative press release and obviously did not read the actual scientific study.
Many study subjects failed to take their calcium-vitamin D supplements
In this study to evaluate the efficacy of calcium and vitamin D compared to placebo, it was startling to learn that many women in the active arm did not take their calcium-vitamin D supplements! According to the study report, about 40% of the women assigned to take calcium and vitamin D did not achieve a standard rate of compliance with their supplements!
When the entire study was tallied, the women in each group (active and placebo) officially remained in their respective group, whether or not they actually followed the study protocol. This meant that women in the active group (the one given the calcium-vitamin D supplements) were counted as having taken the calcium-vitamin D, whether they really took the supplement or not. According to the scientists who conducted this study:
“Participants were followed for major outcomes, regardless of their adherence to the study medication…” 58
The “study medication” mentioned above is the calcium-vitamin D supplement. The fact that a study could be published in a medical journal “regardless” of whether the participants actually took the active ingredient defies logic. The application of common sense would invalidate the findings of this study, regardless of what statisticians might argue.
Placebo group allowed to take calcium and vitamin D
Further confounding the study results were previously unheard-of rules that allowed the placebo group to take multi-vitamin, calcium, and vitamin D supplements on their own if they wanted. It turned out that many in the placebo group were taking calcium and vitamin D. According to the study design, since they were part of the placebo arm, they were officially not taking calcium-vitamin D supplements, even though many of them were indeed taking calcium-vitamin D.
The fact that the placebo group was freely allowed to take multivitamins, calcium and vitamin D meant that many of the placebo participants may have consumed more bone-protecting nutrients (including boron, magnesium, zinc, and manganese) than the active group (who were supposed to be taking only calcium and vitamin D). By failing to separate who was really taking bone-protecting supplements, it was impossible draw a scientific conclusion, yet the media boldly asserted that there was no difference in the hip fracture rate in the group assigned the calcium-vitamin D supplements (many of whom were not taking their supplements) as compared to the placebo group (many who were consuming calcium, vitamin D, and other bone-protecting supplements).

Bone building hormones and drugs also permitted:
Not only was the placebo group allowed to take their own calcium, vitamin D, and other bone-maintenance supplements, but both groups were also allowed to take drugs (bisphosphonates and calcitonin) and hormone therapies that are known to prevent bone loss and restore bone density. In this study that the Federal government spent over $10 million funding, virtually anything was allowed.

Media grossly misleads public:
While the study itself was badly flawed, the media distortion of the findings is nothing short of abominable. Front-page news stories declared calcium-vitamin D supplements had been proven worthless, yet the actual study stated:
“Women receiving calcium with vitamin D supplements had greater preservation of total-hip bone mineral density… 58
“Among women who were adherent (i.e., those who took at least 80 percent of the study medication), calcium with vitamin D supplementation resulted in a 29 percent reduction in hip fracture… 58
“The effect of calcium with vitamin D might require higher doses of vitamin D than were used… 58
“It is also plausible that there was a benefit only among the women who adhered to the study treatment.” 58

As you will read in the June 2006 issue of Life Extension magazine, there are even more serious flaws in this calcium-vitamin D study than what I just described, but it is safe to state that this may have been one of the most poorly designed studies in the history of modern medicine. This did not stop the media from turning it into one of the main headline news stories of the day.
Millions of American women will discard their calcium and vitamin D supplements based on these false and misleading headlines. This is great news for pharmaceutical companies that sell expensive drugs to treat osteoporosis.

Biased attack on glucosamine:
The next victim of the media’s witch hunt was glucosamine, which was one of several agents tested as a treatment for osteoarthritis of the knee.
The media’s deceptive stories were based on a study of people with mild to severe knee pain who were given a form of glucosamine not normally found in dietary supplements. Some participants received this form of glucosamine by itself, while others were given chondroitin sulfate by itself, a combination of glucosamine and chondroitin, or the drug Celebrex®.
The results of this study were encouraging, but the media distorted the findings in a way that made it appear that glucosamine-chondroitin supplements were of little value. A number of media outlets proclaimed that arthritis sufferers were wasting their money by taking glucosamine. While this made compelling headlines, it did not accurately convey what was written in the actual study.
The findings from the actual scientific study made it clear that glucosamine and chondroitin taken together were effective in those with moderate to severe arthritis of the knees. 59

Media may not have read glucosamine study:
The media appears to have relied on a biased editorial that accompanied the actual scientific report on glucosamine. For instance, the New York Times said the following about this arthritis study:
“No effect was found for glucosamine, chondroitin, or the combination of both.” 60
Yet on page 804 of the study (which was published in New England Journal of Medicine, the following was stated about patients with moderate to severe arthritis of the knee who took glucosamine-chondroitin therapy:
“…combined treatment was significantly more effective than placebo” 59
The actual study went on to say that in those with moderate to severe arthritis, the combination of glucosamine-chondroitin resulted in a 24.9% to 26.4% improvement in pain relief. This result exceeded the 20% response to treatment measurement that the scientists themselves stated would prove efficacy. 59
As far as reversing the structural damage inflicted to the knee by osteoarthritis, the scientists stated:
“Treatment with chondroitin sulfate was associated with a significant decrease in the incidence of joint swelling, effusion, or both.” 59
In their concluding remarks, the scientists stated:
“Our finding that the combination of glucosamine and chondroitin sulfate may have some efficacy in patients with moderate-to-severe pain is interesting, but must be confirmed by another trial.” 59
As anyone who understands the English language can read, even this different form of glucosamine, when combined with chondroitin sulfate, demonstrated efficacy in patients most in need, i.e., those with moderate-to-severe pain! The media overlooked these clearly written findings in their haste to viciously attack glucosamine and chondroitin dietary supplements.

Comment: Please don't believe what the media tells you about nutritional studies on face value.

CW

Christopher Wiechert's Healthblogger is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. If you decide to use this information on your own, it's your constitutional right, but I assume no responsibility.

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