/ Food & Drink, Health

The hype over the health claims of food supplements

Array of vitamins and minerals pouring from a bottle

The UK food supplements industry is worth £385m a year. With some supplements not living up to the health claims on their packaging, we could be wasting an awful lot of money on products we don’t need.

Our recent research into food supplements revealed that a third of adults regularly take supplements. This is despite government advice recommending that most people should just eat a balanced and varied diet to get the vitamins they need.

The only people who need to take a supplement (unless it’s been prescribed by a doctor) should be women trying to conceive and in the first 12 weeks of pregnancy (folic acid), children between six months and five years (multivitamin containing vitamins A, C and D), and the over 65s (vitamin D).

Wasting money on food supplements

So why do so many people take supplements, despite not needing them? It’s because they believe they have a positive effect on their health. For example, when we asked people who take glucosamine supplements, 94% said they believed their supplement supports healthy joints and cartilage. However, this health claim has been rejected by the European Union.

Over the past five years, all health claims made on products such as food, drink and supplements have had to be submitted to the EU’s European Food Safety Authority (EFSA). Of 44,000 claims made, only 248 have been approved.

Our research brought Bioglan Probiotic capsules, Bimuno Prebiotic powder and Seven Seas Cardiomax to our attention. All made unproven health claims on their packaging and websites. These related to how they help maintain digestive health such as ‘‘helps maintain digestive balance’’ or ‘‘for a healthy heart”.

Healthy joints and bones

Now, if you do want to take a supplement that’s proven to support healthy joints, take a multivitamin containing vitamins C, D, copper manganese and zinc, as all of these have joint care claims that have been authorised by the EU. A multivitamin’s a lot cheaper too – it costs between 3p and 16p a day, compared to glucosamine supplements which cost 30p to £1 a day. Over the course of a year, you could save up to £354!

We’d like to see all ambiguous and exaggerated claims completely removed from all food supplement packaging, so you can feel confident you’re getting a fair deal.

Do you think supplements are a waste of money? Or do you take supplements regularly and swear by the effect they’ve had on your health?

Comments

” but unless there is evidence that there is a benefit in adopting the Canadian guidelines, I see no reason for doing so. ”

I have a problem with that line as we do have evidence of Vitamin D deficiency being a problem and we also have evidence that countries differ on what is considered advisable. The UK has a great record such as adopting the Australian guidelines on exposure to the sun despite the fact 98% of Australia is nearer the equator than Gibralter is in the northern hemisphere.

This article in 2010 shows the UK and Australia backtracking on the original message pounded in to us over the preceding decade.
http://www.bbc.co.uk/news/health-12013332
and being shy of the sun was leading to this sort of situation:
http://scienceblog.cancerresearchuk.org/2009/09/21/vitamin-d-and-cancer-survival/
http://jco.ascopubs.org/content/27/32/5439.abstract

One interesting trial actually got to the fundamental level of testing using healthy volunteers to take the UK sunshine exposure levels during the winter which lead to this conclusion:

” The majority of the Greater Manchester, UK, white Caucasian nonelderly adult population is predicted to have insufficient (<20 ng ml−1) levels of 25(OH)D during wintertime

Assuming normality, the mean and SD values of the study group were used to calculate the percentage of the Greater Manchester population predicted to have 25(OH)D values, indicating deficient, sufficient, and proposed optimal status (Table 3). Baseline winter data predict that 5% (95% CI: 2.7–8.6) of the population has 25(OH)D levels <5 ng ml−1, 62.5% (CI: 55.2–69.4) has levels <20 ng ml−1, whereas 37.5% (CI: 30.6–44.8) has levels greater than or equal to20 ng ml−1 and only 2.9% (CI: 1.4–5.6) has levels greater than or equal to32 ng ml−1."
http://www.nature.com/jid/journal/v130/n5/full/jid2009417a.html

I understand that life styles, diet, occupation and geographic positions will all make for different results but I think it is undeniable that as a general rule people spend less time out-of-doors than a hundred, thousand or ten thousand years ago.

Some Governments have addressed diet deficiencies to a degree by increasing vitamins/minerals to basic foods however changing eating habits have no doubt reduced the benefits. How much canned drinks were sold in the 1920 compared to milk intake? I mention this because of the reported iodine deficiency outlined here:
http://www.bbc.co.uk/news/health-13034582

So when posters say no supplements I wonder how many posters actually are having iodised salt or eat bread with iodine added.

Jo Huckvale says:
24 August 2013

I am currently taking Bio Care Multivitamins and minerals. I have Fibromyalgia and if I don’t take them I end up having no energy for the day and cannot get anything done. I avoid supplements that contain copper. Did you know that copper can make people feel depressed? It took a Naturopath to tell me that and it has made a huge difference. If you are a person who is not getting all the nutrients necessary from their food though you have a good diet then you learn to be very sensitive to the effects things have on your body. A researcher probably does not have this perceptive ability so there you have a variable that acts negatively on the study. Glucosamine is very subjective perhaps but if you have joint problems then you can certainly tell if it is helping and very quickly too. If you take sugar with it of course the effect is going to be minimized as sugar creates acid and is a rubbish food. Perhaps you could probe manufacturers who put covert sugar in food. As to probiotics – how many people are actually suffering from Candida? Doctors are hopeless at seeing the bigger picture and Candida is certainly a part of this, so is the effect that sugar created endorphins have on people to mask how they truly feel. Reductionism in food and drug technology is not helping anyone because it is utterly superficial. Studies often do not prove very much. More respect should be accorded to people who simply attest that supplements work. Many people have instinctive knowledge, intuition and deep honesty about their bodily processes. A pipsqueak postgrad may have a lot of intellectual grasp of a study but they can lack experience and imagination and they are probably also driven by the ethics of whoever is funding them. All you have offered is generalisations about supplements and while everyone hates a charlaton, these providers of supplements may very well have perceived the need for what they offer and come from a healer’s standpoint as well as a need to make a living. Suggest you stick to testing mechanical things like washing machines and keep away from things that require a deep, honest, introspective approach because you may stop someone getting healing that needs it.

Jane says:
24 August 2013

I think not!!

a1roger says:
24 August 2013

I take about 12 different food supplements every day as I have to try and keep my immune system going.
I’ve no idea whether they work or not and would love to know if there is any proper research evidence.
I do know the company that supplies them is based in the Channel Islands – no doubt for tax purposes – so am guessing it is a highly lucrative business and I do wonder if I’m just being screwed to be frank!
For now – I’d rather be on useless food supplements than semi-toxic prescription drugs – will just have to see what my blood count is at the next test – hum! 🙁 Better still would prefer not to be sending money to The Channel Islands to people who already will be millionaires no doubt!

You prefer “useless food supplememts” to “semi-toxic drugs”. Such extreme alternatives can be avoided. The correct medications, correctly prescribed and dosed, will not be harmful.

I expect what you medically need is available on prescription and would do you good. If you don’t trust your GP to make a proper diagnosis and prescribe the correct treatment, or to refer you to an NHS specialist, then a consultation with a private specialist would probably save money in the long run compared to the cost of buying supplements. What you are taking might possibly be suitable, sufficient, and not excessive. The dosages might be correct for all twelve supplements, but I believe a physician’s expert opinion would be better than relying on chance, luck and hope.

a1roger says:
24 August 2013

Hi John,
You are correct of course and I hope I’ll get the specialists expert opinion in a couple of weeks after I go for latest blood tests and then the results 2 weeks later.
For now they tell me I am “too fit” to be on medication – so that being the case (and I hope it continues that way) – I’m doing what I can – fitness, diet, exercise, 5 a day plus these silly supplements to avoid needing to start on what would then become permanent drugs. They are also expensive so am kind of saving the NHS some money too – never intended to be a burden on the service. So – it’s fingers crossed time.
a1roger

Maria says:
24 August 2013

Hi, a1roger, good to hear you are fit.

The question raised in my mind is whether you have seen a dietitian. Where do you get your information about what to eat and, particularly, which supplements to take from?

For gout it is suggested that high levels of Vitamin C – up to 1,500mg per day you have a 45% lower risk of developing gout compared to men with a vitamin C intake of 250mg per day.

If you do have gout taking high levels of Vitamin C is recommended. An alternative is alluprinol which has some slight risk of dangerous side effects. Vitamin C or a Alluprinol on the NHS ……. I think I know what most would choose.

Certain foods are known to exacerbate gout, so it would make sense to pay attention to diet in an attempt to treat the condition and avoid recurrence. There is little point in taking drugs or supplements if dietary change is all that is needed.

Available evidence suggests that vitamin C is safe in high doses. But thalidomide was believed to be safe at one time.

wavechange – Thank you for the kind advice and you will be pleased to know I have been researching diligently on this for some time. : )

Gout is relatively poorly studied so whilst triggers in diet are known and average age first attacks beyond that the reason why a “proper” diet should still not ward off further attacks is not understood. One thing is known for sure is that large doses of Vitamin C actually reduces the uric acid level in the blood stream.

I have just looked at Wikipedia on the subject and that is very interesting in showing the huge variation in Vitamin C in plants and also that the UK Food Standards recommendation figure is by far the lowest in the West. Curious huh!
http://en.wikipedia.org/wiki/Vitamin_C

One thing I have discovered is that apparently my repeated prescription for gout pain relief pills does not trigger any warnings at my GP surgery. One might think that an exception list on repeat prescriptions would provide a warning that some other action was required. Prolonged attacks can damage joints and even without attacks high levels of uric acid can lead to joint damage.

I was surprised to find that ” If you drink sugar-sweetened soft drinks high in fructose it can cause uric acid to build up.” It then reports a study that two cans a day of this stuff raise the likelihood of an attack by 85%. I never drink pops, beer or alcohol so my chances of cutting down on this trigger seems minimal.!

Dieseltaylor

Decreasing consumption of certain foods is a very well established recommendation to those who suffer from gout. If that is not sufficient, some form of medication is needed to avoid damage as well as the pain.

You are absolutely right to be concerned about long term use of painkillers and allopurinol, and we certainly don’t know why some individuals are troubled with gout whereas others suffer repeatedly. II am one of the lucky ones and having seen others suffer from this painful condition, I’m very grateful. If I did suffer and dietary changes did not help, I might well try vitamin C, on the basis that established treatment is not desirable for long-term use. I would seek medical advice before I embarked on this treatment. Vitamin C is cheap, so at least no-one will be making large profits out of its sale.

Human biochemical pathways are carefully regulated. Taking drugs or supplements has the potential to mess up this control and cause health problems. As people consume more supplements, we might see them taken off open sale. Many assume that ‘more is better’. Vitamin A is a good example where this is very definitely not the case.

I saw reference to soft drinks as dietary triggers when looking up the treatment of gout, when you first mentioned it. This can be explained by some simple biochemistry, though I do not know whether this is a valid explanation. Our bodies are not designed to cope with lots of sugar, but one day we might discover that the same applies with large doses of certain supplements.

It’s amazing, isn’t it, that medical science confesses to only a very limited understanding of the detailed functioning of the immune system, but so many medically untrained people can confidently state that this, that or the other wonder supplement will support your immune system.

Just make sure it doesn’t contrail aristolchia, of course.

JanniMac says:
24 August 2013

I have recently broken my ankle and was suffering restless legs, even the ankle which was in plaster was still jumping, result, agony, disturbed sleep, I could go on, then I read an article about using Magnesium supplement. After a week I only suffer occasionally, believe me this has been a Godsend.

Jo Huckvale says:
29 August 2013

Yep. Magnesium seems to work well for me too for cramps. I also sometimes take cramp bark tea which you can get from Neil’s Yard. Not to everyone’s taste though. Hope it all heals soon.

JanniMac says:
30 August 2013

Thanks Jo. Amazed to get a reply. Wow!!

Bananas have a good magnesium content but, as with all supplementation, dosage is important as well as avoidance of conflicting ingredients.

Jo Huckvale says:
30 August 2013

Bananas have magnesium too? I just learnt something. thanks. Thought it was just potassium. Can’t eat them though as they kick start migraine. But they are a wonderful food – although that being said there is evidently just one type of banana on the market and that is under threat from disease. Love bio-diversity! As far as I’m concerned food comes before supplementation, but if you can’t absorb nutrients then the case for supplements is made no matter how they are presented. It all comes down to chemicals and metabolism and as you say, dosage and conflicting ingredients make it difficult to negotiate. The sad thing is, I’ve never heard any Doctor talking about Orthomolecular medicine -(Wiki is great on it). If Doctors will not take it as seriously as it deserves then I suppose the supplement debate will rage on and on. Probably it is the consumers who will (are?) catch (ing) on first and drive the quest for better knowledge. It really doesn’t seem to work the other way as Physicians’ undoubted high intellects are focussed on magic bullets and the approbation of their fellow professionals who will otherwise shoot them down in flames, something which you cannot afford to do after years of investment of time and money in qualifying.

If it helps you feel less left out, they are all radioactive. Google “banana equivalent dose”

I just dug out my Vitamin D report from July last year which was the year we spent seven weeks in January/February primarily in the tropics followed in May with a lot of of outdoor work building a garden room. My result was 49.3nmol/l which put me as having an insufficiency by 0.5 nmol/l.

Given sunshine is meant to be the primary means for creating Vitamin D this was rather a shock. We have since then be taking Vitamin D3 and I will arrange for a further test next week to see if this summer we have better results.

An early childhood in Australia, and Government propaganda has probably left me over wary of sunshine and most of the time I am wedded to my computer. Having said that the quite minimal amounts of time needed to provide adequate D3 I would have thought I managed. Possibly my skin being aged converts sunlight poorly : ) or the periods I am out in the day early morning or later afternoon mean that the wavelengths needed for making Vitamin D are not available.

This article is very informative:
Human skin pigmentation, migration and disease susceptibility
http://rstb.royalsocietypublishing.org/content/367/1590/785.full.pdf

” Outside of tropical latitudes, large SZAs and increased path lengths result in increased absorption and scattering of the UVB wavelengths responsible for pre-vitamin D3 production in the skin [17–21]. The presence or absence of sunlight is not a good guide to the presence or absence of UVB [22], and for much of the year outside of the tropics there is little or no UVB in sunlight, except at very high altitudes [3]. At the equator,by contrast,UVB irradiance is high throughout the year and exhibits peaks at the two equinoxes and nadirs at the two solstices [ 3]. This results in an
annual range of variation of about 20 per cent at the equator in vitamin D3 -inducing wavelengths of UVB. In contrast, at 50 degrees N, there is a difference of 250 per cent in vitamin D3-inducing wavelengths of UVB over the course of the year, with the nadir in the solar winter from November to February exhibiting no effective vitamin D3-inducing wavelengths of UVB [9]”

Eileen says:
25 August 2013

If glucosamine can affect genes does that mean that it should be classified as a vitamin? If the elderly need higher levels of vitamin D perhaps its the same for glucosamine and that we need more as we get older.

There is no evidence of this. NHS Choices is a good resource for this kind of thing: http://www.nhs.uk/news/2010/09September/Pages/osteoarthritis-supplements-of-no-benefit.aspx

Eileen

Glucosamine is classified as a dietary supplement and not a vitamin. Vitamins are essential components of our diet with well established biochemical roles and well known symptoms if we do not get enough of them.

Very little of the glucosamine taken orally ends up in the bloodstream, so it is either digested or excreted if eaten. I have no idea what happens if it is given intravenously, into muscles or into joints, but no doubt these options have been tested. No doubt research will continue and if administration of glucosamine in any form proves to have a significant effect I am sure the news will make the headlines.

Alsmum says:
25 August 2013

I have been taking Imedeen for some years now thinking it was good for my skin.I have been reading the information on supplements in these articles and do wonder whether I should be continuing to take it.Can anyone help me in where I can find good independent advice on taking Imedeen.I would like to know if continuing taking it is safe and whether there is good evidence for its claims.

I would be astounded if it had the effect claimed by its proponents. Read the actual claims made by Boots etc. and you’ll find they are much more modest: when you see text like “to help” or “can help” then you’re usually looking at sciencey-sounding marketing claims. Something that genuinely works will have an unequivocal statement that it does X, not some weasel-worded ASA-compliant arm-waving about how it might “help with” it.

If the advert is worded like a shampoo advert, then it’s quackery 🙂

Seems to me that as it is a beauty product [?] it automatically falls under the highly unlikely to be effective for what it claims.!! In the sense that if it makes you feel good why not. From the point of view of can it do you harm I know not. If you are being economical with your cash I would ditch it.

I give a link here to Wikipedia but bear in mind that contributors to it may well have a vested interest.
http://en.wikipedia.org/wiki/Beauty_products
Of particular note:
“It is important to make use of sunscreen to protect the skin from sun damage; sunscreen should be applied at least 20 minutes before exposure, and should be re-applied every four hours. Sunscreen should be applied to all areas of the skin that will be exposed to sunlight, and at least a tablespoon (25 ml) should be applied to each limb, the face, chest, and back, to ensure thorough coverage. Many tinted moisturizers, foundations and primers now contain some form of SPF.”

So we can imagine a scenario where as ladies age they worry more about wrinkles so cover up or apply more sun screen and reduce possible production of Vitamin D. Nice to have a joined up attitude to sunshine where different articles [Which? please note] deal with only part of a picture and in essence mislead.

hi Alsmum

I’ve had a quick look online and I can’t see which Imedeen supplement you’re taking as there seem to be a few that it could be – the Derma one? Time perfection? or the anti-aging one?

If you’d like to let us know I can look up the claims. Alternatively you could look up the claims yourself and see whether they are authorised or not using the EU Register of Health and Nutrition claims http://ec.europa.eu/nuhclaims/

Shefalee

Antonio Gandarinho says:
25 August 2013

What I would like to know is if there are any scientific reasons why glucosamine supplements do not do what they are said to do, or if no one has scientifically proven the effect, therefore being a mere placebo.
Does anyone know where the idea comes from? Why is it said to support healthy joints and cartilage?

Maria says:
25 August 2013

According to wiki, the hypothesis is that, “since glucosamine is a precursor for glycosaminoglycans, and glycosaminoglycans are a major component of joint cartilage, supplemental glucosamine may influence cartilage structure, and so may apply to alleviation of arthritis”.

I think your first question is addressed in my response to Michael G. above, posted 23 August 2013 at 3:15 pm. In a nutshell, studies have been contradictory but the best quality ones indicate no effect beyond placebo; the amount of glucosamine in supplements is a tiny fraction of what the body itself produces, which casts doubt on plausibility.

Sugars are precursors of glucosamine, but we don’t recommend eating sugar to treat arthritis. As Maria has said, dietary glucosamine is not a significant source of glucosamine compared with what is in the diet.

Oops. The last sentence should say: …. dietary glucosamine is not a significant source of glucosamine compared with what is made by in our bodies.

If supplements and additional vitamins were necessary for good health GPs would be allowed to prescribe them. The fact that apart from a few exceptions they are not allowed to do so should reassure us that in general supplements and additional vitamins are unnecessary.( Exceptions include patients with pernicious anaemia who require vitamin B12 injections, rare cases of scurvy due to gross vitamin C deficiency, the at risk groups for vitamin D deficiency and alcoholics who require large doses of the B vitamins usually in hospital.)

Dave

Browsing the BNF suggests that GPs can prescribe a wider range of vitamins than the ones you have mentioned. It is reassuring to see the following statement: “Their use as general ‘pick-me-ups’ is of unproven value and, in the case of preparations containing vitamin A or D, may actually be harmful if patients take more than the prescribed dose. The ‘fad’ for mega-vitamin therapy with water-soluble vitamins, such as ascorbic acid and pyridoxine, is unscientific and can be harmful.”

dave – I think your logic is faulty. The NHS doctors do not give prescriptions for healthy food but that does not mean they do not recommend it. You will note the new guidelines on supplements for the elderly as another case where the population, rightly, is expected to read, digest, and pay for it themselves.

wavechange – Quoting the British Nutritional Foundation! : )
However it did lead me to this very interesting free paper on proper hydration of children:
http://onlinelibrary.wiley.com/doi/10.1111/nbu.12028/full

” In children, dehydration has been shown to affect cognitive function and studies have suggested that the number of children who may be dehydrated at school is alarmingly high. A study of 452 schoolchildren in the UK, aged 9–11 years (recruited from several schools from Sheffield), found 60% of children arrived at school inadequately hydrated (Friedlander 2012). Another study of 298 schoolchildren from year 2 (aged 6–7 years) and year 5 (aged 9–10 years) from six schools in Southampton found that once children arrived at school 71% did not drink enough fluid throughout the day to maintain an adequate hydration level (Kaushik et al. 2007). A recent small intervention study of 15 schoolchildren (aged 8–9 years) in the UK demonstrated that drinking an additional glass of water (∼200 ml) could significantly improve their ability in tasks that involved visual attention and fine motor skills. The authors concluded that it is likely the positive effects of water supplementation would also extend to classroom-based activities such as handwriting and copying text (Booth et al. 2012).”

Dieseltaylor

I’m sorry for not mentioning that the BNF I referred to is the British National Formulary, a book listing the drugs that can be prescribed under the NHS and some that cannot. GPs usually have a copy on their desk. It gives brief information about drugs and their usage in the treatment of common conditions. It is very useful and the public can register to use it online.

The British Nutrition Foundation has come in for some criticism from knowledgeable contributors to other Conversations. The author of the article you refer to is supported by the Natural Hydration Council, whose members sell bottled water.

Don’t diabetics often have B12 injections because the drug they are taking for diabetes depletes the body of iron? A side effect in other words.

I wonder how many other cases like this there are?

Mark says:
26 August 2013

The Medicines & Healthcare Products Regulatory Authority have licensed glucosamine for relief of mild to moderate arthritic pain and as such is evidence-based medicine. Dietitians are the experts in all this and can and should be prescribing glucosamine in suc circumstances. Perhaps the dietitians association can make a statement about what is in their dietetics practice manual on this subject.

Maria says:
26 August 2013

Mark

The fact that a treatment is licensed by the MHRA doesn’t mean that it works. I’m sure you know that doctors have prescribed many useless licensed treatments over the years. As is clear from the public assessment report, the MHRA license granted to Tenlec Pharma to market Glucosamine Sulphate as Glusartel for the relief of symptoms of mild to moderate osteoarthritis of the knee wasn’t based on the best or most up-to-date evidence available. However, in the absence of anything better, it will undoubtedly continue to be prescribed and I’m not sure why you think the dietitians associations needs to tell us about what their practice manual says on the subject.

Yes, the MHRA granted a license for homeopathic teething granules, active ingredient: none.

Jo Huckvale says:
29 August 2013

Wrong. Ingredient camomile. Have used it in the distant past for babies teething. Quite helpful and babies don’t do placebo.

Mark says:
26 August 2013

Good for you Maria, well done!

Maria says:
26 August 2013

For what?

The pharmaceutical industry pushes out the most dangerous drugs know to man with profits over 10 billion a year. And yet you are grumbling over a petty amount of money for supplements that at least give people hope and without the dangers of the like of Statins. What a sorry life this is where it’s OK for over 780,000 people who died in America last year from medical drug side effects and God knows how many died in Uk, and yet the so called expert? Will have you know that you could get diarrhoea from taking a supplement. By the way Statins have never been proven to extend your life or stop you getting a heart attack or stroke? And yet millions of people here are being pushed by the medical profession to take this very dangerous drug!!

Jo Huckvale says:
27 August 2013

I agree wholeheartedly with grumpyoldman. We are being fed lie after lie after lie, and all so the bosses drug companies can get rich. Time to go back to healing, integrity and a wholesome attitude to folk/orthomolecular medicine. There are people out there with many answers to many problems. Time they were heard and time we encouraged each other to take more responsibility for our own health.

Maria says:
28 August 2013

The only relevant part of grumpyoldman’s comment was the suggestion that anyone is “grumbling over a petty amount of money for supplements that at least give people hope” If, instead of ‘hope’ he’d said ‘the placebo effect’, there might have been a point worth debating. But surely nobody seriously thinks that several hundred pounds a year is a “petty amount” to pay for hope alone, without any ultimate benefit? It certainly wouldn’t be to me.

Jo Huckvale, I take it from your comment about drug company bosses that you agree with the general thrust of the above article on unnecessary supplements. Apart from that, I don’t see the relevance of your comment either. The article is about supplements not folklore v science.

Maria says:
28 August 2013

Taking supplements is what a lot of people think of as ‘taking responsibility for our own health’, by the way.

Jo Huckvale says:
28 August 2013

No Maria. You haven’t read it right at all. I am talking about drug companies, not supplements companies. Medicine is now a machine. I am talking about HEALING. If people try taking supplements it is often because the medical profession has already failed them, not listened and is not regarding them holistically. Doctors are pressured by drugs companies and by their own colleagues who cling together for professional support. Someone taking supplements is already trying to take responsibility for their own health. It should go further than that though. If you still carry on taking the foods that are lacking in nutrition (the valueless sort you buy at a corner store), of course the effect of a supplement is not going to be very obvious. Supplements are part of an ongoing journey at taking responsibility for your own health and there are many other systems such as Ayurveda and yes, homeopathy, which have value, and to re-iterate a previous, valuable, comment about Vets, animals don’t know about the placebo effect. Drug companies do not like other businesses who encourage people to think for themselves and question what is put into their bodies.

Maria says:
28 August 2013

Jo said,

“If people try taking supplements it is often because the medical profession has already failed them, not listened and is not regarding them holistically.”

It may be because they feel they have been failed by the medical profession but that does not mean either that ‘medicine is a machine’, (whatever that is supposed to mean), or that supplements are going to help them.

You appear to be unaware that ‘drug companies’ and ‘supplement companies’ are often one and the same. Pharmaceutical companies like Merck and GlaxoSmithKline, produce supplements for profit as do supplement companies so the distinction is immaterial, given than most people take supplements not because they’ve been failed by anything but because of heavy and dishonest marketing by the nutraceutical industry. The target market for OTC vitamin pills and suchlike are the ‘worried well’ and, according to nutritional physician Alan Stewart, this group are the main consumers, while those who might benefit because of their vulnerable health and inadequate diets aren’t bothering. (Source: Interview, C4 Food Hospital).

Again, I’m ignoring the off-topic and irrelevant content of your comment. The topic here is the hype over the health claims of food supplements. Got an opinion on that?

Jo, perhaps you aren’t aware that SCAM is a ,ultimate-billion-dollar industry? Or that it spends orders of magnitude more on marketing, proportionally, than th pharmaceutical industry? Or ta it is largely exempt from any requirement to prove efficacy, thanks to assiduous lobbying?

I think a level playing field would be good, don’t you?

Jo Huckvale says:
29 August 2013

Quod erat demonstrandum! Exactly. the Pharmas muscled in on what they saw was a profitable market.
We have had hype over snake oil for centuries, but fortunately, more people are now able to use their intelligence and powers of discretion and they should have the freedom to trial a product themselves that they think might be helpful. We are just emerging from a time when people believed everything the Doctor told them. How can this not be a good thing? I think it is time people and companies and researchers started pooling their knowledge and thought about the greater good beyond Patents. I notice some comments here have recourse to Wiki, it isn’t gospel either, but it’s a start. There are people out there with the answers to many human physical and mental problems, old remedies, new breakthroughs. Good feedback is the key not point scoring.

Jo

Who needs the NHS and the benefit of years of research, sharing of results and conclusions via scientific journals and years of education to work as general practitioners and specialists? Intelligence, powers of discretion and the freedom to trial products are obviously a better an alternative in your opinion. That suits me because it means that there might be less drain on NHS reserves, at least in the short term.

Conventional medicines have allowed me to live a reasonably normal life and possibly saved my life. I would prefer if GPs issued more advice and less pills, but even those who reject supplements are a bit to keen on thinking that the taking medicines is the answer to everything.

My present GP is very good and she takes the time to explain treatment and is open to ideas and suggestions. The practice has a helpful website and, as I mentioned on another Conversation?, there is a link to Quackwatch.

I guess we will have to agree to differ.

Jo Huckvale says:
29 August 2013

I don’t disagree at all, Wavechange. Why would anyone think that study and research do not also rate highly with someone who quite rightly wants more from the Western system of medicine? I just think that GPs are pressured by drug companies, pressured by colleagues and the medical ‘Establishment’ and therefore lose contact with the body’s ability to heal itself. A holistic and open minded approach such as your Doctor seems to have is a very good thing. Sadly, not all of them have this gift. It is simply crazy that people are dished out pills, simply to then have other pills to cancel the side effects of those and so on. I have never met anyone who likes this scenario, especially the elderly who so often have to resort to isphagula and water pills. There are so many alternatives and supplementation is just one of them. Looking after people requires imagination as well as formulaic approaches. And, ahh, you have reminded me of how the older generation in my youth always referred both cynically and lovingly to the family doctor as The Quack! Be well!

I’m sure that we have a lot to agree on regarding overuse of conventional drugs. I don’t know if it is standard procedure, but my GP practice does medication reviews about twice a year, something that should have been done years ago.

But there is not that much difference between some supplements and the drugs prescribed by GPs, except that the latter have all been through exhaustive tests for safety, and dosages and side-effects have been documented and updated as necessary.

What concerns me about supplements is that they are often taken with little or no evidence of need. Our bodies are very complex and balanced systems and subjecting them to a collection of chemicals in the form of supplements might upset the balance. That happens even with chemicals such as salt and monosodium glutamate in food.

Perhaps the way forward is to carry out tests to determine if we need supplements. Are we deficient in vitamins, for example. As I said earlier, I am disappointed that the NHS does not routinely test blood glucose to identify those at risk of developing diabetes, a serious condition that places great demands on the NHS. If I suspected a vitamin deficiency I would first ask my GP to be tested, and if that was declined, I would pay for the test myself rather than swallowing chemicals.

You are concerned about GPs dishing out pills and so am I. I’m also concerned about people taking supplements they don’t need, thanks largely to the power of marketing.

Mark says:
30 August 2013

How do GPs test for choline deficiency?

Marion R. says:
30 August 2013

While the earth and her abundance provide everything that the human body needs to live, there are 3 key facts about vitamins and minerals that separate our simple ability to survive from our capability to thrive and live a full and active life.
1)Your body can’t produce them. Vitamins and minerals are called “essential” because they are needed to sustain life and health, and almost all must be obtained from our diet.
2)The human body is not capable of storing most vitamins and minerals, so optimal health relies on nourishing the body with ideal amounts throughout the day. Deficiencies today can hurt tomorrow!
3) Your body prioritizes health needs like doctors prioritize ER patients. As a result, you may not feel an immediate difference if you to a few days without essential vitamins and minerals, but you are jeopardizing long-term health benefits.
Plants make 11 of the 13 vitamins essential for human health. Fruits and veggies are the main source and primary manufacturer of the vitamins we need to survive. How many of us actually eat a healthy amount of fruits and veggies EVERY day?And don’t forget, we need to drink water as well!! So many people are depriving our bodies of the very nutrition it needs to stay healthy, fight disease, combat stress and cope with free radicals that we are constantly bombarded with EVERY day of our lives from internal and external forces!!

Jo Huckvale says:
30 August 2013

Too right.

It seems to me that there is a powerful case for much better health education on diet and well-being to combat the influence of commercial promotion. I am concerned that too many people who can ill afford, or might be at risk from, unprescribed supplementation do not realise how much they could do to help themselves without synthetic preparartions.

I wish people did not feel inhibited [or deterrred] from asking their GP for advice unless they are really ill, I wish “primary care practices” would make themselves more accessible [with information, support and periodic tests] and put more emphasis on making patients welcome, and I wish pharmacists – who are as highly-trained as doctors – would be less laissez-faire in the selling of unprescribed products. I happen to believe that the overwhelming majority of GP’s and pharmacists practise very professionally, and responsibly, and give expert advice, but many people do have serious concerns – as Jo Huckvale exemplifies above – and I think the NHS must address this.

Marion R. says:
30 August 2013

Most of us are over fed and under nourished! Just look at the habits of people around you.SO many people are heavier than is healthy. Fast food, microwave meals, ready meals, fruit and veg picked weeks before they are ripe,lack of exercise… I could go on and on…Advertising by big name companies is aimed at luring the public into believing that this product and that product will be a benefit to them when all they are really interested in is making themselves more profit. The health of the consumer is the least of concern of the big name companies…in my opinion

MarionR wrote: “The human body is not capable of storing most vitamins and minerals, so optimal health relies on nourishing the body with ideal amounts throughout the day. Deficiencies today can hurt tomorrow!”

Our bodies are perfectly capable of coping with day-to-day variations in vitamin and mineral intake. A sensible approach is to look at what we have eaten in the past week and use this information to plan for the following week.

Maria says:
31 August 2013

MarionR wrote: “Most of us are over fed and under nourished! Just look at the habits of people around you.SO many people are heavier than is healthy.”

Seeing people overeat and get fat tells us only that they are overeating and fat, not that they are ‘undernourished’. Life expectancy and mortality statistics for the UK don’t appear to support the claim that “most of us are undernourished” so I’m wondering where this comes from?

Maria

I agree, though I do not have the statistics to hand.

Rather than claiming that many people are undernourished, it would be better to stick to less controversial claims, such as those relating to obesity and consumption of excessive amounts of sugar, refined carbohydrates, saturated fats and salt.

Jo Huckvale says:
31 August 2013

One reason some people overeat is because their bodies tell them they are not getting the nutrients they need. It’s vicious circle. Then again, there are many people whose metabolisms do not work as they should and so they do not absorb what they should from their food. Many manufactured foods stimulate production of endorphins so they build up a habit of addiction that is difficult to kick. It is NOT their fault. It is their metabolism. (See Katherine Desmaisons. I expect she is on Wiki. Certainly in Amazon.) People with IBS similarly do not make use of nutrients as is necessary, so MarionR is right in saying that people can be undernourished in a western society. Sadly, also, if pre-natal nutrition is bad, especially in the first trimester, a child may have hidden health problems stored up for later life. I used to make multi-nutrient shakes with ground up egg shells when I was carrying my first two children thirty-six years ago. Maybe it was a good move in terms of mitigating a hereditary pectus which could impact on the chest cavity. What would you offer to a pregnant woman who had a diagnosed milk allergy? Supplements, I bet. Not everyone want to grind up egg shells. Then again, there are the wild goats who used to come and lick the nutrient rich salt flats at Lake Maligne in the Rockies every spring after giving birth. SUPPLEMENTATION. It’s nat’ral. There are people who lick the earth off potatoes. I would rather something clean from a small jar but preferably not at too high a price. And for the arthritis ridden, I wonder if the new generation ‘glucosamine’ replacement containing Boswellia has been tested yet? Which?

Another reason why people overeat is ready availability and choice of food that needs little or no preparation. Blame the supermarkets, blame marketing or blame lack of self-control, but just letting people decide on what they should eat has left us with a substantial number of people in the UK who are overweight or obese.

I fear that allowing people to decide on use of supplements is leading to unwise choices and many are consuming products they don’t need. At best they are wasting their money and supporting companies exploiting fear and ignorance, and at worst their health could suffer in the long term. I have nothing against use of supplements where their use is indicated to treat specific medical conditions or established need, and support testing to establish that need.

Jane says:
31 August 2013

To conclude!!! Marketing through fear has convinced a huge majority of frightened and badly informed people they need extra vits. How on earth do they know? They don’t! As mentioned above we are all overflowing with nutrients- just look around!
I cannot believe this discussion is still going on! Am now headed to the greasy spoon for a fry- up!! What better? Coming………?

Maria says:
31 August 2013

I’ll see you there, Jane. 🙂

Jane says:
31 August 2013

🙂

I feel It is fair to mention that the medical establishment itself has actually established that a need for supplementation exists by the act of recommending them. This is undeniable.

I was involved in the early trials of folic acid for mothers – following the death in the womb of our first two malformed children. My belief than and now that if a mother does not drink milk but a litre of more a day of Coke then problems will ensue. However the trial was not about that. Fortunately our subsequent children were fine.

The UK government recommends supplementation of diet over 65 – so the concept of supplements is recommended. The argument should not be about supplements in general but ones where severe doubts exist as there value AND this distinction should be hammered home not a generalised swipe at “supplements”

I do not think anyone is criticising use of supplements where appropriate. At present, there are NHS recommendations for the young, the elderly, during pregnancy, plus use for individuals with certain conditions. Some foods (e.g. cornflakes) are supplemented because their processing removes most of the natural vitamins.

One of the problems is the pressure from advertising, peer pressure, etc. for the rest of the population to swallow supplements and sometimes in large and potentially harmful amounts. The other is the misleading and sometimes dishonest claims of efficacy of supplements.

I am very sorry to hear about your first children, Dieseltaylor. Medical knowledge has advanced greatly in our lives and will continue to do so. It worries me greatly that so many people are swallowing unnecessary supplements when we have little knowledge of whether they could be harmful. I hope my concerns are unfounded.

Thanks wavechange.

Given my view on Coke and the results in my life it is no great surprise I am not a fan.

I am curious that if sodas/pop/cokes were described as supplementing normal diet whether they would be subject to more scrutiny than they are. It seems very much that they add actually nil value to diet and on balance are harmful which begs the question why what has become established as a “drink” has no standards to cross.

http://www.rodale.com/facts-about-soda?page=0

This article below talks of water fluoridation being forced upon a population to lower dental requirements. Consider the consumption of soft drinks and effects on teeth and then wonder if perhaps we are intent on treating effects rather than causes.

http://www.dailymail.co.uk/health/article-1156783/Fluoride-water–dont-want-it.html

Apparently the average person drinks 107 litres per annum of carbonated water up 7 litres over 7 years and I would be surprised if this were not an inverse to milk consumption.
http://www.britishsoftdrinks.com/PDF/UK%20soft%20drinks%20report%202012.pdf

Interesting reading especially taken in context with:

“One of the most consistent and powerful findings is the link between soft drink intake and increased energy consumption. Fully 10 of 12 cross-sectional studies, 5 of 5 longitudinal studies, and all 4 of the long-term experimental studies examined showed that energy intake rises when soft drink consumption increases. The effect sizes for these studies, respectively, were 0.13, 0.24, and 0.30.

The available literature also supports the observation that people do not adequately compensate for the added energy they consume in soft drinks with their intake of other foods and consequently increase their intake of sugar and total energy. ………”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1829363/

Its funny really that Which? does not have a pop [!] at the soft drinks industry which seems a big enough target with plenty of kudos for helping naive consumers.

I agree that it would be good for Which? to look at our consumption of soft drinks. Thanks for the link to the article in American Journal of Public Health, which makes interesting reading.

BSDA may think I am drinking the soft drinks I buy, but they are for visitors and most is discarded.

It would be good to have a Conversation about soft drinks. Many consume bottles of fresh orange juice or cartons of reconstituted stuff, on the basis that it contains vitamin C and other useful nutrients. We all need to be aware that drinking these convenient fruit juices is a very easy way of consuming a considerable amount of sugar.

I’m aware that some of the supplement science that appears to work in test tubes or on paper either does not work inside the human body or has an effect opposite to that intended; I recall reading of trials with some so-called anti-oxidant vitamins had to be stopped because the theorizing of pseudo-scientists proved to be 180 degrees out.

But I’m also aware that tests on vegetables have shown that they can contain far lower, and inadequate, levels of micro-nutrients than items grown in the same soil decades earlier. Also, factors such as a vegetarian diet and caffeine intake may lead to deficiencies in certain minerals.

The field has been hijacked by quacks, charlatans, pseudo-scientists and big business. Even if you hate the control that the European Commission has on everyday things, you have to be grateful someone has done something to try and rein in the rogue elements in the industry.

Years ago there used to be a Which? offshoot – was it Which? Health – and analytical trials of the contents of some supplements were carried out merely to check the stated ingredients (not to test any claims of efficacy). I remember that some supplement manufacturers kicked up such a fuss over the results and the test methods that Which? abandoned such testing and it all went suspiciously quiet.

I do hope Which? is now returning to this topic to bring a bit of real science into the picture.

I don’t disagree with you Martin but I am conscious that ” had to be stopped because the theorizing of pseudo-scientists proved to be 180 degrees out.” that not all great discoveries had the blessing of established medicine :

http://en.wikipedia.org/wiki/Barry_Marshall

Rather bizarrely he may have been the third man to discover the same cure. The first pre-WW2 but I cannot find the link.

John Lykoudis
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John Lykoudis (1910 in Missolonghi – 1980) was a general practitioner in Greece who treated patients suffering from peptic ulcer disease with antibiotics long before it was commonly recognized that bacteria were a dominant cause for the disease.

After treating himself for peptic ulcer disease with antibiotics in 1958 and finding the treatment effective he began treating patients with antibiotics. After experimenting with several combinations of antibiotics he eventually arrived at a combination which he termed Elgaco and which he patented in 1961. It has been estimated that he treated more than 30,000 patients.

In his time he had great difficulties in persuading the Greek medical establishment about the effectiveness of the treatment. He was given a fine of 4000 drachmas by a disciplinary committee, and indicted in the Greek courts. He was unable to get an article published in the Journal of the American Medical Association and was not able to get the established pharmaceutical companies sufficiently interested in the treatment.

John Lykoudis was the mayor of Missolonghi between 1952 and 1960.

As I see it, Which? is alerting us to the fact that many are buying supplements that are probably unnecessary and that some manufacturers are making claims that cannot be justified. No doubt Which? will alert the Advertising Standards Authority and others to the latter problem, as it has done in other cases of non-compliance with the rules. I am very grateful for the input from the EU, for the reasons you mention, Martin.

I would like to see Which? directing us to reliable sources of information that make use of good science and continuing to alert us to unsubstantiated claims.

Diesltaylor: The case of h pylori and ulcer is an interesting one in that it is both a great demonstration of how medicine can discard incorrect beliefs in the face of objective evidence (something that is simply not possible for most forms of quackery), and an example of the quality of evidence that is needed to overturn opinion.

Lykoudis was up against not only orthodox opinion but also an immature science around bacteria and their ability to live in acid environments. The shift in opinion required oth evidence of effect *and* underlying mechanism. Much evidence-based medicine ignores the requirement for solid underlying science, which is why there are endless clinical trials of things based on provably wrong theories – homeopathy and acupuncture, for example.

A fine argument but is it not slightly flawed that regardless of the science of the 1950’s surely the evidence of cured patients warranted a little bit more than to be ignored. It is rather amusing to think if the same had happened now that with the better media coverage and the Internet whether the evidence could have been ignored. Even in the 1980’s it was not plain sailing as this nice article reveals:
http://science.org.au/scientists/interviews/w/rw.html

My Vitamin C dose for gout is recommended despite no one being able to give a satisfactory theory for how it works.

I am against quack medicine but let us not pretend that there are not vast commercial interests and a conservative medical profession with vested interests to protect. The fact that the pharmaceutical industry spends more on advertising than research should not be forgotten as an indicator that making money is the primary aim. That it includes setting up bogus medical journals to report favourable results and the suppressing of unfavourable reports means a lot of medical information, such as that on the dangers of smoking, is twisted.

The supplements industry is so similar in its actions it is quite mirror-like. : )

Matthew says:
3 September 2013

Nice long list of DOCTORS who say vitamins are safe and effective.

http://orthomolecular.org/resources/omns/v08n09.shtml

click Back To Archive and relieve yourself of the close minded posters on this thread.

One small problem: that’s basically a lobby group for the supplement industry.

The safety of many supplements is unknown, and the safety of some at the doses proposed by the more extreme “orthomolecular” folks is completely unknown; the efficacy is in general unproven and often disproven.

Homeostasis means that the body is evolved to get rid of excess of most nutrients, but it’s not possible to consume enough fruit to get tot he thousands of milligrams of vitamin C proposed by some of the cranks.

The evidence for systemic need for broad-scale supplementation in the general population is weak, to put it charitably. It’s worth repeating that the human race would not have survived this long if a normal diet (which ranges from fruit and nuts in some populations to fish, fat and no fruit in others) did not provide the necessary nutrition. It’s quite possible that ageing populations may require, for example, Vitamin D supplementation, but the idea that large numbers of supplements are necessary for health is an extraordinary claim that requires correspondingly substantial evidence.

I wonder how many of them routinely test for vitamin deficiency before prescribing large doses of vitamins.

Jo Huckvale says:
4 September 2013

Thanks Matthew for this refreshing website on Orthomolecular medicine. Encouraging – as are the people I know locally who run very helpful Health food shops and have loads of positive feedback from customers that then gets shared with others – A good way of sharing health knowhow. I find these people and their customers are very open minded, knowledgeable and committed to good health. One of the comments of the Doctors on the website you found will also be very appropriate from a personal health point of view, so thanks for that. I can recommend googling digestive enzymes too as another aid to health.
Although it has been a revelation, must now bow out of these conversations on supplements as there are other things that require the time.

Matthew says:
22 December 2013

I like gardening too.

Matthew says:
22 December 2013

No need for a prescription mate.

We’ve rounded up some of your comments if you’d like to join the latest debate: https://conversation.which.co.uk/energy-home/food-supplements-vitamins-health-diet-multivitamin-comments/

Maria says:
3 September 2013

No thanks. That just looks like a continuation of this debate. Don’t see the point.

That’s OK Maria. It’s a chance for us to feature some of you in the debate itself, and give one of you Comment of the Week. Often Conversations end quite quickly, and so we like to give them another boost with a comment round-up. Happy for you to continue chatting here if you’d prefer 🙂