Comments on: Nutrition Attrition

Nutrition Attrition

kidkilowatt — Tue, 11 Jun 2013 03:27:43 -0800

"Don't forget to take your vitamins!" Or not. Some say it could kill you. Will there ever be any definitive answers when it comes to nutrition?

By: ambrosen

ambrosen — Tue, 11 Jun 2013 03:45:00 -0800

In terms of nutrition advice, I find "Eat food. Not too much. Mostly plants." to be pretty much definitive.

By: twistedonion

twistedonion — Tue, 11 Jun 2013 03:46:01 -0800

"Will there ever be any definitive answers when it comes to nutrition?" Same as most things in life. Common sense is the way forward. Devouring too much of anything is probably harmful to health.

By: pracowity

pracowity — Tue, 11 Jun 2013 03:50:05 -0800

Oh, dear.

Nutrition experts argue that people need only the recommended daily allowance — the amount of vitamins found in a routine diet. Vitamin manufacturers argue that a regular diet doesn't contain enough vitamins, and that more is better.

Should I believe the doctors who don't (or shouldn't, anyway) have anything to gain one way or the other as long as their patients come out healthy? Or should I believe the manufacturers who now make billions of dollars every year from selling vitamin supplements added to everything?

By: pompomtom

pompomtom — Tue, 11 Jun 2013 03:54:15 -0800

more is better Ask Xavier Mertz. Oh, right.

By: flapjax at midnite

flapjax at midnite — Tue, 11 Jun 2013 04:05:42 -0800

Vitamin manufacturers argue that a regular diet doesn't contain enough vitamins Yeah, a *regular* diet, for a great number of Americans, probably doesn't. But of course they should improve their diet, not buy a bunch of fucking vitamins.

By: Ralston McTodd

Ralston McTodd — Tue, 11 Jun 2013 04:12:23 -0800

The whole "common sense/eat food" idea is just as much a cultural product of its time as the belief that nutrition consists of discrete vitamins consumed in isolation, and there's something moralistic about it. If supplements worked, that just wouldn't be fair to the people with the willpower to eat the right foods and the time to prepare them. So do I believe supplement manufacturers who stand to make a lot of money or experts influenced by a culture where health is increasingly seen as tied to personal virtue? I'm really not sure.

By: Didymium

Didymium — Tue, 11 Jun 2013 04:15:22 -0800

My wife and I have arguments about vitamins all the time. She's pro- and I'm anti-vitamin. So, I love articles like this! Thanks! but the truth is that I just don't want to be bothered to take vitamins...

By: cotterpin

cotterpin — Tue, 11 Jun 2013 04:23:11 -0800

Will there ever be any definitive answers when it comes to nutrition? No one is going to fund a study to show that carrots are healthy. This is the greater truth of the food industry: the science of nutrition, when applied, is always going to try to convince you that isolated or processed food is just as healthy as whole food. I don't believe it anymore, because the science always seems to change every ten years to recommend something new. Products on the shelf always seem to get healthier and healthier, which is really ironic when you think about it. That's why my favorite piece of nutrition advice is this, "the active ingredient in broccoli is broccoli". In case it's not clear, it's not really advice about veggies at all. It's about the idea that what you eat can have an active ingredient. What's the active ingredient in a vitamin? Which is good food, beta carotene or a carrot? When you take a step back, this sounds like the foolishness it is. Which is better, eating vitamins or not eating vitamins? It's irrelevant. Let me rephrase that question in a way that will actually help: Which is better, eating a carrot or eating empty calories and a vitamin? Then the answer becomes obvious.

By: eriko

eriko — Tue, 11 Jun 2013 04:23:15 -0800

It's kind of like drinking. If you drink, you die. If you don't drink, you die anyway.

By: The 10th Regiment of Foot

The 10th Regiment of Foot — Tue, 11 Jun 2013 04:25:21 -0800

they should improve their diet, not buy a bunch of fucking vitamins Can I get that in a pill form for that feeling of instant gratification?

By: dowcrag

dowcrag — Tue, 11 Jun 2013 04:28:48 -0800

Isn't it sort of old news that taking antioxidant vitamins like A, C, E etc as vitamins rather than from foods can be counterproductive? Recent Guardian article with lots more detail and studies. From near the bottom: "Not all the news is grim. Some dietary supplements actually might be of value. Of the 51,000 new supplements on the market, four might be of benefit for otherwise healthy people: omega-3 fatty acids to prevent heart disease; calcium and vitamin D in postmenopausal women, to prevent bone thinning; and folic acid during pregnancy, to prevent birth defects." I stick to omega 3, vitamin D when it's not sunny (I'm in the UK so that's a lot of the time) and some B's if I'm under a lot of stress, but I also try to get all these from foods.

By: Ivan Fyodorovich

Ivan Fyodorovich — Tue, 11 Jun 2013 04:30:18 -0800

"Yeah, a *regular* diet, for a great number of Americans, probably doesn't." You think so? I don't. I think that probably a significant number of people are slightly deficient on one or two, and not even chronically, but otherwise almost all Americans are getting a sufficient amount of these essential nutrients from their diet. The problem with American diets is that we're getting a whole bunch of stuff we shouldn't be getting, not that we're not getting enough of what we should. But the latter "problem" can be "solved" by a huge manufacturing and retail industry selling us stuff and the former cannot.

By: sammyo

sammyo — Tue, 11 Jun 2013 04:30:36 -0800

Oh just cut out all the stuff in the middle.

By: logonym

logonym — Tue, 11 Jun 2013 04:31:28 -0800

There is enough research that contradicts other research that everyone can shoot holes in other people's nutrition position. So it gets like religion. On vitamins, some of them are to be avoided, especially by some people. Smokers, former smokers, and people exposed to asbestos should never take supplemental beta-carotene. People with Mediterranean anemia shouldn't ever take supplemental iron unless a doctor advised it and was monitoring the situation.(Actually I think most people shouldn't do iron except when lab work shows you need) People prone to some kinds of kidney stones shouldn't megadose vitamin C because it can increase their risk. Vitamin E and selenium are Dr Jekyl and Mr Hyde about cancer risk, increasing some cancers in some studies decreasing them in others. And every day some tenant of nutrition and vitamins gets turned upside down. And they are really certain about the new data. Its for real, until a couple years later.

By: Peach

Peach — Tue, 11 Jun 2013 04:33:30 -0800

Sigh. I have lived through so many waves of vehement exhortations about magic food habits. Yes, it does seem so compelling to think that things you put in your mouth (or don't put in your mouth) have the capacity to transform you. Allow you to magically transcend your basic animal nature. It can seem equally compelling to deny everything, to celebrate gluttony and to rejoice in Cheetos and cheesesteaks, to embrace the culture of consumption. Or to take all the power by starving yourself. That said, I take a daily vitamin, and fish oil, plus calcium and glucosamine chondroitin, and I'm on the Weight Watchers program. I eat food, not too much, mostly plants (that can get really expensive), and I exercise regularly. And I will get old, and I will die.

By: alasdair

alasdair — Tue, 11 Jun 2013 04:34:14 -0800

Will there ever be any definitive answers when it comes to nutrition? Do please correct me, but "eat more fruit and vegetables, eat less other stuff" has been the main message of every piece of dietary advice I've seen forever - certainly since I was a child in the 1980s. There might be some changes - fat versus cereals, for example - but the key theme is always consistent: more fruit and vegetables, less other stuff. The trouble is that the advice is hard and unpleasant to follow, not that the advice keeps changing. Saying it changes all the time is an excuse for us to not have to eat all that fruit and all those vegetables. "Oh, the advice keeps changing! I'll just eat this jam doughnut instead of this broccoli because, you know, it might turn out that jam doughnuts are better tomorrow!" No, it won't. The broccoli will always be better, and the jam doughnut will always be nicer. We tell ourselves stories to justify our moral failure to eat all that damn cabbage, and one of the stories is "the advice keeps changing", but it's a story and it's not true. For the record: I do not eat the fruit and vegetables I should. I eat too much other stuff, notably fatty and sugary stuff and booze. I do hardly any exercise. This makes me feel bad and morally inferior (weak willed). You are probably the same. My story is "I'll eat better tomorrow!" But it's a story, just like "there are no definitive answers!", and neither are true.

By: The 10th Regiment of Foot

The 10th Regiment of Foot — Tue, 11 Jun 2013 04:34:28 -0800

And every day some tenant of nutrition and vitamins gets turned upside down. That may or may not be true, but the solution is not to just go ahead and take the pill and hope that someday there's a study that justifies your actions. A better choice would be not to take the pill until they definatively say that it's OK.

By: OnceUponATime

OnceUponATime — Tue, 11 Jun 2013 04:59:22 -0800

Yeah, the "Will there ever be any definitive answers when it comes to nutrition?" framing bugs me. Did reputable scientists ever actually claim that taking "mega" doses of vitamins was good for you?Because I don't remember that. I remember being told that being deficient in essential vitamins is bad for you, and that a multivitamin could be a kind of nutritional insurance, and not to take more than one of my multivitamins per day. As a kid, I totally would've eaten the whole bottle of Flintstones vitamins otherwise. Because too much of some vitamins is bad for you. That's what they told me when I was growing up in the '80s, and that's what this article is saying. But what do I know? I'm still trying to live by this revised food pyramid from 2002.

By: astapasta24

astapasta24 — Tue, 11 Jun 2013 05:17:02 -0800

I'm really wondering how much of the increased risk of death is actually attributable to the effects on vitamins on the human body and how much of the increased risk of death is attributable to human choice. What I mean is...I wonder how many people thought, "Hey, I'll keep doing this unhealthy thing because my vitamin will help balance things out right?"

By: The 10th Regiment of Foot

The 10th Regiment of Foot — Tue, 11 Jun 2013 05:24:54 -0800

I'm really wondering how much of the increased risk of death is actually attributable to the effects on vitamins on the human body and how much of the increased risk of death is attributable to human choice. Isn't that what the control was for in the clinical trials?

By: tocts

tocts — Tue, 11 Jun 2013 05:26:22 -0800

What I mean is...I wonder how many people thought, "Hey, I'll keep doing this unhealthy thing because my vitamin will help balance things out right?" People who run scientific studies do in fact consider such possibilities, and work to negate such effects by careful study design. Note, for example, the study that showed more deaths from lung cancer and heart disease among smokers who took beta carotene or vitamin E. There was a control group that took a placebo. That group did not know they weren't taking vitamins, and so if there was any effect based on people assuming "I took vitamins and therefore can do unhealthy things', that would have shown up in the placebo group as well.

By: usonian

usonian — Tue, 11 Jun 2013 05:32:02 -0800

This is the best song about vitamins.

By: usonian

usonian — Tue, 11 Jun 2013 05:35:09 -0800

(ugh, please ignore random best friends 4eva slideshow tacked on at the end.)

By: Seymour Zamboni

Seymour Zamboni — Tue, 11 Jun 2013 05:38:27 -0800

As ambrosen points out, I think Michael Pollan's advice is pretty sensible. In a way, the processed food makers are really no different than the pill makers. Look at cereal. I think it is General Mills that puts that thumbs up or big check mark on its boxes because you get your daily dose of "whole grains" when you eat Lucky Charms*. The claim that a cereal like that is good for your kids or anybody else because it contains whole grains is really no different than fantastic claims made by pill makers. *All those vibrant artificial colors used for the little marshmallows produce technicolor poop. Fun for the kids! Maybe that should be their new marketing campaign.

By: dowcrag

dowcrag — Tue, 11 Jun 2013 05:51:36 -0800

Old but good (might need a 'previously' tag as well). It's based in part on Cochrane studies and each bubble represents not only the supplement but also the specific benefit being tested. Hover to see the benefit then click to see the study. The fact that antioxidants can be both promising and a waste of time depending on what you're looking for just demonstrates the complexity of all this...

By: Namlit

Namlit — Tue, 11 Jun 2013 05:59:37 -0800

It's really like with anyone manufacturing processed things that can be ingested, and making money on it. Why would anyone believe them when they say their products are needed? I never have this kind of argument with the dirt in my yard when I'm going to fetch a carrot.

By: box

box — Tue, 11 Jun 2013 06:04:18 -0800

There's a food blogger I read that has a Facebook account, which he uses largely for, like, crowd-participation stuff. The other day, he wrote 'Which vegetable is under-utilized by most restaurants?' I thought about it a little, and, honestly, other than lettuce, tomato and potatoes, I think the answer might be 'all of them.'

By: The 10th Regiment of Foot

The 10th Regiment of Foot — Tue, 11 Jun 2013 06:05:21 -0800

I never have this kind of argument with the dirt in my yard when I'm going to fetch a carrot. But you do from the fertilizer manufacturers who tell you to supplement your soil.

By: EmpressCallipygos

EmpressCallipygos — Tue, 11 Jun 2013 06:18:33 -0800

It's not just the average normal diet that's probably okay without vitamin supplements, it's also the average person that's probably okay with out them. But not a one of us is necessarily "average" or "normal." We all have our individual idiosyncracies; some of us may need more of one vitamin, some of us may have difficulties digesting/absorbing another. I know that I do better with a Vitamin D supplement, and that a magnesium supplement helps me stay on top of my insomnia. Someone else may not have the same biochemistry, and may need a little extra of something else. So just like food - everyone may respond differently to vitamins, and may need more or not. So making universal pronouncements make no sense unless they're watered-down like crazy.

By: Huck500

Huck500 — Tue, 11 Jun 2013 06:21:44 -0800

The broccoli will always be better, and the jam doughnut will always be nicer. When I turned 40 (4 years ago) my brain just up and decided that broccoli is indeed nicer than a jam doughnut, and right now it seems to be in the process of deciding that fish + veggies are much nicer than a hamburger, and that drinking lots of alcohol isn't so nice... I wish I knew why the hell, so I could write a book or something.

By: antinomia

antinomia — Tue, 11 Jun 2013 06:40:52 -0800

I just completed my dietetic internship (supervised practice before becoming a registered dietitian) during which I worked in a hospital, a cancer center, and an eating disorder clinic. I found actual vitamin deficiencies to be very very rare. The general population has a sufficiently varied diet that they are not going to experience acute deficiencies. The exceptions: - alchoholics. Alcohol abuse causes thiamin deficiency, to the extent that when people are admitted to the hospital they have altered mental status (agitated and confused) when sober, caused by the deficiency. It's standard practice that they are given thiamin and their thiamin levels are monitored while they're admitted. - vitamin D. Vitamin D deficiencies are very common, and deficiencies are linked to increased rates of cancer, hypertension, and fractures in the elderly (from osteoporosis), while vit D supplements are not associated with side effects when taken long-term. This is a vitamin worth taking if you are deficient since there are very few natural sources (basically fatty fish and liver, don't trust milk fortification because it's not monitored or enforced). - vitamin B12 in the elderly. As we age our stomachs produce less secretions, and one of those secretions is required to absorb B12. The result is that the elderly (people in their 80s and above) benefit from supplemental B12. Deficiency results in memory loss and foggy thinking, often confused with a symptom of just being old. - People with severe intestinal disorders (Chrohn's or cancer) or with cystic fibrosis or pancreatic disorders, that prevent them from absorbing fat soluble vitamins (A,D,E and K). If you don't fall into one of these categories, you're probably fine. That being said, if you are a health maximizer, your best bet is to eat a variety of whole foods, including lots of green leafy veg (for magnesium, vit K, folate, potassium, vit A), and beans (folate and fiber), while excluding red meat and avoiding foods with added sugars. And take your vit D if you've been tested and are deficient.

By: Kurichina

Kurichina — Tue, 11 Jun 2013 06:40:59 -0800

It's also not too difficult to be tested for vitamin deficiencies, if one is unsure. My doctor tests every one of her patients for Vitamin D (which is why I'm taking 2000 IU/day at her recommendation), and a physician friend recommends all Canadians supplement with Vitamin D because we don't get as much sunlight as we need, but people in sunnier climes wouldn't need any extra Vitamin D at all, most likely. Other vitamins may not be as necessary, as long as one eats a healthy, varied diet. That's not easy for manufacturers to market to, though. Having Katy Perry endorse large doses of one particular multivitamin is a lot easier if you want to sell stuff.

By: Namlit

Namlit — Tue, 11 Jun 2013 07:21:05 -0800

But you do from the fertilizer manufacturers who tell you to supplement your soil. And that's just the beauty of it: I don't. We have our own compost. And while it wriggles, it rarely talks to me.

By: C'est la D.C.

C'est la D.C. — Tue, 11 Jun 2013 07:23:23 -0800

I stumbled across something that drove me nuts awhile back. I was reading the book Pandora's Lunchbox because I'm really interested in how processed food is produced, and there was a chapter on naturally occurring vs artificially introduced vitamins. The author tries to float the argument that too many vitamins are bad for us based on a study that fed animals large doses of various vitamins and selenium (a micro-nutrient) and found that they fell ill. I can't decide if the author didn't understand micro-nutrients or was just cherry picking information that fit her bias. I mean, at the risk of being hyperbolic, there's a reason that we clean up Superfund sites for selenium and not Vitamin A.

By: thirteenkiller

thirteenkiller — Tue, 11 Jun 2013 07:30:57 -0800

Gardening is fun and simple and there's a certain appeal in playing the bemused farmer in the face of all this processed food talk, but "natural" does not always mean "healthy" and even carrots have a centuries-long history of manipulation at the hands of humans.

By: thirteenkiller

thirteenkiller — Tue, 11 Jun 2013 07:36:31 -0800

Do please correct me, but "eat more fruit and vegetables, eat less other stuff" has been the main message of every piece of dietary advice I've seen forever - certainly since I was a child in the 1980s. There might be some changes - fat versus cereals, for example - but the key theme is always consistent: more fruit and vegetables, less other stuff. Fruit contains a lot of sugar, so some dietary advice these days includes limiting fruit.

By: Ouisch

Ouisch — Tue, 11 Jun 2013 07:39:32 -0800

Vitamins don't seem to cure much of anything aside from vitamin deficiencies which are, like, antinomia says above, relatively rare among average, healthy people who have enough to eat. The advice to eat more fruits and vegetables is indeed pretty consistent for several decades now. Even Pollan's nifty little statement basically sums up what the mainstream nutrition/public health establishment has been saying for a while. That doesn't make it unimpeachable advice (for instance, there really are people, even in rich countries, who don't have enough to eat, and there are also people with eating disorders and other health problems for whom that advice doesn't work very well), but it has been pretty consistent, despite the seeming confusion about nutrition research. Part of the problem behind the confusion is that preliminary evidence is reported both by the media and often by research institutes' own PR departments as definitive, new, groundbreaking reversals on previously-held beliefs about nutrition. Getting definitive answers about nutrition -- especially in terms of the total diet or whole foods instead of specific nutrients that can be condensed into a pill (and a similar-looking placebo) and used in double-blinded studies -- is difficult and expensive and takes a long time. You have to randomize people to specific diets, ensure that they adhere to them and measure that adherence (hard to do because dietary measurement tools are burdensome and not always accurate), try to account for other confounding variables (hard to do in a free-living population), and follow them for years at a time (over which adherence to the diet is likely to break down), and make sure that you measure outcomes and endpoints that really matter, like disease incidence and deaths. It's not easy or cheap, so it's not often done. Instead, we get big headlines about the Study of the Month showing that people who once checked off that they eat cantaloupe forty times a day on a food frequency questionnaire live 0.2 years longer (after 40 years follow-up, within which time their diet was never again assessed) than their counterparts. And it's reported with the same (or more) gusto than the same, boring, old-hat nutrition recommendations that have been around for years. Because it's more psychologically satisfying, somehow, and of course it sells things (papers, cantaloupes, maybe supplements.)

By: Mental Wimp

Mental Wimp — Tue, 11 Jun 2013 07:46:33 -0800

In some cockeyed inversion of logic, many people who deplore big pharma devour handfuls of anything promoted as a dietary supplement. Go figure.

By: BlueHorse

BlueHorse — Tue, 11 Jun 2013 07:53:21 -0800

And that's just the beauty of it: I don't. We have our own compost. And while it wriggles, it rarely talks to me. Ah, yes. Compost. Oodles of horse, chicken and some cow manure. Pine chips from the chicken shed. Old weeds fermented. Why yes, I do believe in many kinds of crap. Just not corporate crap. I will be out in the garden grubbing a few handfuls of vitamins.

By: srboisvert

srboisvert — Tue, 11 Jun 2013 08:15:08 -0800

I watch this pretty closely and I'll still continue taking a daily multivitamin supplement. My reasoning: My diet is potentially deficient. I don't eat nearly enough fruits or vegetables. I try but I don't succeed. I know this. My diet is potentially worse than average. I'm in my late forties. So should I heed studies that aggregate data over a large population of people, including large numbers of people who are not like me, and that tend to conflate normal multivitamin supplements with people who take megadose vitamins? My answer at the moment is no. So I take a multivitamin every day. Not a megadose pill. Just the run of the mill supplement. The thing I worry about more than the actual hazards of taking a multivitamin is that I have no idea if the pill I am taking actually contains what it says it contains in the amounts it says but hey this America and that is the way the handgun cylinder spins here.

By: Silvertree

Silvertree — Tue, 11 Jun 2013 08:22:11 -0800

This article is better written than most, but remember the mainstream media often has problems when covering science. Consequently, getting sound nutritional advice is difficult at best. Note: I used "mainstream media" in the descriptive sense, not pejoratively.

By: antinomia

antinomia — Tue, 11 Jun 2013 08:33:36 -0800

srboisvert, try consumerlab.com. They do independent testing of supplements do determine if what it says on the label is there, if it's bioavailable/absorbable, and if it's contaminated. Sort of like consumer reports for supplements. Personally, I don't trust supplement companies because of the lax regulation. Basically a way to make big money with little overhead since you can use your customers as your guinea pigs.

By: elsietheeel

elsietheeel — Tue, 11 Jun 2013 09:04:13 -0800

I think as weight loss surgeries become more common you will see more vitamin deficiencies. I've been deficient B1, B6, and B12, as well as vitamin D and iron. I've spent most of the past 4 years in varying stages of anemia now that the reduced contents of my tiny stomach no longer pass through the duodenum. (I'm fine now, thanks to vitamin supplements.)

By: Emperor SnooKloze

Emperor SnooKloze — Tue, 11 Jun 2013 09:11:03 -0800

It's useful to keep in mind, I think, a distinction that I think Pollan mentions (or at least alludes to): the difference between nutrition, and nutritionism. Seems to me that one discusses how what we eat contributes to the building and maintenance of the physical being, and the other is how we can maximize the number of isolated and packaged chemicals we schlork down.

By: nTeleKy

nTeleKy — Tue, 11 Jun 2013 09:22:40 -0800

I'm still partial to Kompressor's Vitamins Are Good. I had a vitamin D deficiency (yay desk jobs in winter climates). It was really low and I was taking between 2000-10,000 IU/day for over 6 months before they got back to normal. It seems like the article lists a select few vitamins that can cause problems when overconsumed which is good to know and then extrapolates that to "Are vitamins an OK thing?" which is not really even a legitimate question.

By: kozad

kozad — Tue, 11 Jun 2013 09:35:12 -0800

It's useful to keep in mind, I think, a distinction that I think Pollan mentions (or at least alludes to): the difference between nutrition, and nutritionism. This is like the difference between science and scientism.

By: Schmucko

Schmucko — Tue, 11 Jun 2013 09:40:17 -0800

The nutrition news really does swing around. In the 90s I thought I was being healthy substituting margarine for butter, but now we know that margarine was the worst fat (trans fats). I also would take beta carotene or vitamin E. Now vitamin promoters say one needs all different forms of vitamins A and E (gamma tocopherol, etc.) Supplements--which can include not just vitamins but minerals and herbs (St. John's wort for mood, valerian for sleep, turmeric for inflammation), or amino acids, or other compounds like creatine people take for gym performance--can give people a feeling of control in tweaking aspects of their health. Of course there's the placebo effect, and this is all subject to reversals in research just as for beta carotene or vitamin E.

By: bongo_x

bongo_x — Tue, 11 Jun 2013 10:54:04 -0800

Did reputable scientists ever actually claim that taking "mega" doses of vitamins was good for you?Because I don't remember that. People listen to fads, or ads, and then years later throw their hands in the air "they're always saying something different!" without asking who they is. Often they keep saying something different because they are different people trying to sell you different things. Sure, science makes new and conflicting reports, but that's not the same as some guy with an infomercial. When I turned 40 (4 years ago) my brain just up and decided that broccoli is indeed nicer than a jam doughnut, Me, also, as well. I'm not sure if it's just my taste changing from changing my diet, or something that just happened. I eat any junk I want one day a week, that's my rule, but there are whole categories of junk I want no part of. I have no desire for a Big Mac, or a jelly donut. Not if you paid me. As a kid I could barely choke down vegetables and rarely ate them as a young adult. Now I prefer them to most things.

By: Mental Wimp

Mental Wimp — Tue, 11 Jun 2013 10:58:14 -0800

The nutrition news really does swing around. This is a problem with observational research. Most epidemiologists do not appreciate just how large the biases can be and often wave hands at these potential threats to validity. If they did account for the uncertainty the biases introduce, they'd never hit the magical p = 0.05 it takes to get published in the American Journal of Epidemiology or whatever, so they're really not incentivized to account for it. Randomized trials, people. Accept no substitute.

By: vespabelle

vespabelle — Tue, 11 Jun 2013 11:25:50 -0800

Silvertree, Offit's a very well known pediatrician who developed the rotavirus vaccine and has written extensively on vaccines. He's not just a journalist.

By: 7life

7life — Tue, 11 Jun 2013 12:55:40 -0800

Fruit contains a lot of sugar, so some dietary advice these days includes limiting fruit. That is true but to put things in perspective there are about 20g of sugar in an apple as opposed to 60 g in 20 oz coke (which is pretty much a single serving in the US nowadays). It is very easy to get 3 servings of coke in a day. Every day. Can you imagine doing so with 10 apples a day? There will be people doing too much of a good thing always, that is true. And doing everything in excess is hazardous to your health. Drinking too much water will kill you. But there needs to be no qualifier for the advice of "drink plenty of water" I feel the same way with fruits. Eat more veggies and fruits imho, is, always has been, and will always be good advice. (Fruit juice on the other hand...)

By: Foolhardy

Foolhardy — Tue, 11 Jun 2013 13:34:32 -0800

No one is going to fund a study to show that carrots are healthy [...] That's why my favorite piece of nutrition advice is this, "the active ingredient in broccoli is broccoli". In case it's not clear, it's not really advice about veggies at all. It's about the idea that what you eat can have an active ingredient. If a study were to find that carrots were healthy, it wouldn't be very helpful because carrots contain thousands of organic compounds, any combination of which could be responsible for the effects. Surely some of those did not contribute to health, but if you only test the whole package of components that make the carrot, it won't help you find out which is which. We humans are chemical systems, made up of specific chemicals, processes and systems. With a sufficiently detailed and accurate model of how we work chemically, it would be possible to say exactly what nutrients what people need in what quantities and at what times. I think it's worthwhile to work toward that. These studies are one way of doing that. Organic chemistry is an enormous field that is very complex and hard to study; we only understand parts of how it works so far. It's too early to know exactly what should go into food. I agree that the best generic advice at this point is something like "Eat food. Not too much. Mostly plants." I also think that we will be able to be able to provide more precise and confident advice in the future, and that it will be a good thing.

By: thirteenkiller

thirteenkiller — Tue, 11 Jun 2013 13:39:44 -0800

It's pretty easy to imagine having two bananas (25 g of sugar each) and a 1/4 cup of raisins (15 g sugar) in your day; add that to the five servings of grains or whatever USDA says these days and it starts to be rather a lot of carbohydrates. Of course fruit won't ever be as bad as drinking three huge Cokes a day, but most things look good compared to that. Beside that, though, my point is that "eat more fruit", while common advice in some diet paradigms, is far from uncontested.

By: Foolhardy

Foolhardy — Tue, 11 Jun 2013 14:03:33 -0800

It's pretty easy to imagine having two bananas (25 g of sugar each) [...] Sugar? Did you stop to consider the radiation dose of those bananas?? :)

By: thirteenkiller

thirteenkiller — Tue, 11 Jun 2013 14:18:17 -0800

By: Peach

Peach — Tue, 11 Jun 2013 14:36:26 -0800

Sometimes I do eat two bananas a day. Mostly I don't. But even if I did, it wouldn't be the same as eating nothing but Hamburger Helper.

By: thirteenkiller

thirteenkiller — Tue, 11 Jun 2013 18:45:36 -0800

Well, that's definitely true.

By: stavrosthewonderchicken

stavrosthewonderchicken — Wed, 12 Jun 2013 02:42:35 -0800

I eat healthily and exercise regularly, but I also take B complex, D and Co-Q10. In terms of the B and Co-Q10 at least, I feel noticably more alert and energetic when I take them. I'm willing to admit that there might be some placebo effect to that, but I don't really care: I like having more energy, regardless of where it comes from.

By: logonym

logonym — Wed, 12 Jun 2013 03:21:37 -0800

Vitamin supplements have certainly at times done more harm than good for particular groups. How many deaths occur from aspirin every year? How many ER visits from aspirin adverse effects? Do deaths and adverse effects mean no one should take aspirin ever again. Or that aspirin should only be available by prescription? A certain segment of drugs and other health aids is almost always going to have to available without physician consultation. Physicians sometimes prescribe stupidly. I assure you this is true. Sometimes laymen are going to choose poorly from the the range of things from which they can pick, mostly supplements and OTC drugs. OTC drugs really have insufficient data on the label as do supplements as do prescription drugs. And none of us are told enough about the possibility that a killer bee in our proximity could get hit by gamma rays and become a super-soldier killer bee with nearly God like attributes. What I'm asking is, given how many Doctor recommended remedies have some horrible risks? Specific vitamins have unacceptable risks for certain people with certain conditions. The value of vitamins taken generally by the general population for non-specific ailments seems to statistically maybe not be good. Continue to educate about probabilities as we understand them but lets not forget evidence based medicine is very risky. Hospital and clinic acquired infections are at levels most medical authorities find unacceptable. We have mainstream stories about the lack of evidence for vitamins and their potential risk. Do we have commensurate stories about the risk of metformin causing B-12 deficiency sometimes or statins causing fatigue and memory problems. Yes those things have gotten mentions. Were the mentions really as prominent as the vitamins could actually be bad stories. Do prescription drug risks get as much attention as vitamin risks- especially considering the potential magnitude. Some Rx drugs carry warnings about Q_T elongation and potential sudden death. Do patients have enough informed consent about the issue. Should there be news stories about it. What about the rare but very devastating Stevens-Johnson syndrome. Does it need media attention. Quite a few Rx can do it.

By: ludwig_van

ludwig_van — Wed, 12 Jun 2013 05:49:26 -0800

If you want to look up the research into the effects of a particular supplement, examine.com is an excellent resource, and improving all the time. As some commenters mentioned above, for most people, vitamin D and omega 3 supplementation are a good idea and cover most of the bases.

By: Mental Wimp

Mental Wimp — Wed, 12 Jun 2013 09:41:46 -0800

I like having more energy, regardless of where it comes from. I suggest amphetamines.

By: stavrosthewonderchicken

stavrosthewonderchicken — Wed, 12 Jun 2013 17:22:02 -0800

I suggest amphetamines. You jest, but in my youth, I had ample experience with speed in its various forms.

By: flapjax at midnite

flapjax at midnite — Wed, 12 Jun 2013 17:28:13 -0800

I'm still shaking.