Celebs decry evidence on vitamin pills

[mr blur]

From The Guardian's wonderful Bad Science series:

And so our ongoing project to learn about evidence through nonsense enters its sixth improbable year. This week the assembled celebrity community and vitamin pill industry will walk us through the pitfalls of reading through a systematic review and meta-analysis from the Cochrane Collaboration, an international not-for-profit organisation set up 20 years ago to create transparent, systematic, unbiased reviews of the medical literature on everything from drugs, through surgery, to community interventions.

Last week Cochrane produced a gold-standard review, looking at 67 trials describing the experiences of 230,000 people, which showed that antioxidant vitamin pills do not reduce deaths, and in fact may increase your chance of dying.

In the Health Food Manufacturers' Association press release Gloria Hunniford and Sir Cliff Richard issued their definitive refutations. Carole Caplin said: "It must be obvious to everyone who hasn't got a vested interest in supplements that this review is absolute rubbish, it contains fundamental flaws." In a press release issued on behalf of the food supplement industry. Criticising an academic collaboration which does not accept any corporate funding.

So what were these flaws? The pill community was worried by the way that trials were selected for inclusion in the group analysis.

The ex-head of the Harley Street Hale Clinic, Dr Rajendra Sharma - a man who advertises his use of a "bioresonance" machine called the Quantum Xrroid Consciousness Interface to diagnose his patients - explained science to the nation on More4 News: "The writers of this study started with 16,000 studies, and we're asking the question, why did it go down to 68 . Clearly there's a bias that we're not yet quite sure about." Let the mystery be revealed. The answer to his question can be found in figure 1 of the Cochrane report (which of course he read). Of the 16,111 studies which the Cochrane authors found - by using search terms in databases - 12,703 were duplicates, 983 were in children and so not applicable to this review's predescribed remit, and so on.

<snip>

http://www.guardian.co.uk/commentisfree/2008/apr/26/medicalresearch.health

[Warpy]

1. OK, now you've done it. You were warned, you know.

:popcorn:

[HysteryDiagnosis]

2. ...

"Cannot be used to treat, diagnose nor cure any disease", poppycock.


1 Recruiting Use of Formula Fortified With DHA in Infants With Cystic Fibrosis
Condition: Cystic Fibrosis
Interventions: Dietary Supplement: Docosahexaenoic acid (DHA); Dietary Supplement: Standard formula (Enfamil)

2 Active, not recruiting Effects of Prenatal DHA Supplements on Infant Development
Condition: Pregnancy
Interventions: Dietary Supplement: DHA; Dietary Supplement: Placebo

3 Active, not recruiting DHA (Docosahexaenoic Acid), an Omega 3 Fatty Acid, in Slowing the Progression of Alzheimer's Disease
Condition: Alzheimer's Disease
Interventions: Drug: DHA (Docosahexaenoic Acid); Drug: Placebo

4 Recruiting Effects of Docosahexaenoic Acid (DHA) on Cognitive Function in Children 4 Years of Age
Condition: Healthy
Intervention: Behavioral: DHA dietary supplementation

5 Active, not recruiting Influence of DHA-Rich Supplement on DHA-Status and Health Evolution of Patients With Cystic Fibrosis
Condition: Cystic Fibrosis
Intervention: Drug: Giving DHA-rich supplement versus placebo

6 Active, not recruiting Evaluation of DHA for the Treatment of PSC
Conditions: Primary Sclerosing Cholangitis; Colitis
Intervention: Drug: Docosahexaenoic Acid (DHA)

7 Active, not recruiting Effect of 8-Week Dietary DHA Supplementation on Cerebral Blood Flow and Metabolic Function
Conditions: Healthy; Attention
Intervention: Dietary Supplement: docosahexaenoic acid

8 Recruiting Memory Improvement With Docosahexaenoic Acid Study (MIDAS)
Conditions: Age-Related Cognitive Decline; Age-Related Memory Disorders
Intervention: Dietary Supplement: DHA (nutritional supplement) or placebo

9 Completed Effect of DHA Supplements on Macular Function in Patients With Stargardt Macular Dystrophy and Stargardt-Like Macular Dystrophy
Condition: Macular Degeneration
Intervention: Drug: Docosahexaenoic Acid (DHA) Dietary Supplement

10 Active, not recruiting DHA Supplementation in Patients With STGD3
Condition: Dominantly Inherited Stargardt's Disease (STGD3)
Intervention: Drug: Over the counter DHA/EPA dietary supplementation

11 Recruiting The Triglyceride Lowering Effect of an Omega-3 Fat (DHA) in Addition to Statin Therapy for Patients With
CAD or Diabetes
Conditions: Hypertriglyceridemia (TG>200<500); Hyperlipidemia; Coronary Artery Disease; Coronary Risk Equivalent; Diabetes
Intervention: Drug: docosahexanoic acid (DHA)

12 Recruiting DHA Supplementation and Pregnancy Outcome
Condition: Pregnancy
Intervention: Procedure: Docosahexaenoic acid or DHA

13 Active, not recruiting DHA-Paclitaxel in Treating Patients With Metastatic Pancreatic Cancer
Condition: Pancreatic Cancer
Interventions: Drug: DHA-paclitaxel; Procedure: chemotherapy

14 Active, not recruiting DHA-Paclitaxel in Treating Patients With Metastatic Colorectal Cancer
Condition: Colorectal Cancer
Interventions: Drug: DHA-paclitaxel; Procedure: chemotherapy

15 Active, not recruiting DHA-Paclitaxel in Treating Patients With Metastatic Prostate Cancer
Condition: Prostate Cancer
Interventions: Drug: DHA-paclitaxel; Procedure: chemotherapy

16 Recruiting Efficacy of Docosahexaenoic Acid on Tardive Dyskinesia
Condition: Tardive Dyskinesia
Interventions: Dietary Supplement: Omega-3 fish oil capsules (including DHA); Dietary Supplement: Placebo

17 Recruiting Safety and Effectiveness of Omega
3-Fatty Acids, EPA Versus DHA, for the Treatment of Major Depression
Condition: Major Depressive Disorder
Interventions: Dietary Supplement: eicosapentanoic acid; Dietary Supplement: docosahexanoic acid; Dietary Supplement: Placebo

18 Recruiting Nutritional Intervention to Prevent Diabetes
Condition: Type 1 Diabetes Mellitus
Intervention: Drug: Docosahexaenoic acid (DHA)

19 Recruiting PET Imaging of DHA Metabolism
Condition: Healthy
Intervention:

20 Completed A Randomized Clinical Trial on Supplementation of DHA and AA to Preterm Infants
Condition: Infant, Low Birth Weight
Intervention: Procedure: Supplement of fatty acid (DHA and AA)

21 Recruiting N-3 Fatty Acid Requirements for Human Development
Condition: Pregnancy
Interventions: Dietary Supplement: omega 3 fatty acids; Dietary Supplement: vegetable oil

22 Recruiting DHA and X-Linked Retinitis Pigmentosa
Conditions: Retinitis Pigmentosa; X-Linked Genetic Diseases
Intervention: Drug: docosahexaenoic acid

23 Recruiting Age-Related Eye Disease Study 2 (AREDS2)
Condition: Age-Related Macular Degeneration
Interventions: Dietary Supplement: Lutein/zeaxanthin; Dietary Supplement: Omega-3 long-chain polyunsaturated fatty acids; Drug: Lutein/zeaxanthin and Omega-3 long-chain polyunsaturated fatty acids

24 Recruiting Omega-3 Fatty Acids for Treating Adults With Major Depression
Condition: Depression
Interventions: Dietary Supplement: EPA omega-3 fatty acid; Dietary Supplement: DHA omega-3 fatty acid; Dietary Supplement: Placebo comparator

25 Active, not recruiting Chemotherapy in Treating Patients With Metastatic Kidney Cancer
Condition: Kidney Cancer
Interventions: Drug: DHA-paclitaxel; Procedure: chemotherapy

26 Completed Docosahexaenoic Acid in the Treatment of Autism

Condition: Autistic Disorder
Interventions: Dietary Supplement: docosahexaenoic acid (DHA); Dietary Supplement: Placebo

27 Completed Docosaexahenoic Acid and Gross Motor Milestones in Infants
Condition: Healthy
Intervention: Dietary Supplement: Docosahexaenoic acid (DHA)

28 Active, not recruiting Study of Docosahexaenoic Acid (DHA) Supplementation in Patients With X-Linked Retinitis Pigmentosa
Condition: Retinitis Pigmentosa
Intervention: Drug: docosahexaenoic acid

33 Completed Use of Omega-3 Fatty Acids for Perinatal Depression
Conditions: Depression; Depression, Postpartum
Interventions: Drug: Omega-3 Fatty Acids (EPA plus DHA); Behavioral: Supportive psychotherapy; Drug: Placebo

34 Recruiting Effects of Omega-3 Fatty Acids on Bone and Frailty
Conditions: Osteoporosis; Frailty
Interventions: Dietary Supplement: DHA/EPA; Dietary Supplement: Placebo capsule; Dietary Supplement: Calcium with vitamin D

35 Completed Preliminary Study of Fish Oil and Dementia
Conditions: Alzheimer's Disease; Mild Cognitive Impairment
Intervention: Dietary Supplement: omega-3 polyunsaturated fatty acids ( EPA+DHA)

36 Recruiting Polyunsaturated Fatty Acids (PUFA) in the Treatment of Non-Alcoholic Steatohepatitis (NASH) in Patients With Type 2 Diabetes Mellitus (PUFA)
Condition: Fatty Liver
Interventions: Drug: PUFA (Opti-EPA); Drug: Placebo

37 Recruiting Study of Pharmacokinetics and Pharmacodynamics of Artesunate in Pregnant Women in the Democratic Republic of Congo
Condition: Malaria
Intervention: Drug: Artesunate

38 Completed Nutrition and Cognition in Indian Children
Condition: Healthy
Intervention: Behavioral: micronutrients

39 Completed Efficacy and Safety of Dihydroartemisinin/Piperaquine (Artekin®) for the Treatment of Uncomplicated Malaria in Peru
Condition: Malaria
Intervention: Drug: Dihydroartemisinin/piperaquine VS. Mefloquine + Artesunate

40 Active, not recruiting Activity of Essential Fatty Acid Elongation/Desaturation Pathway During Early Life in Human Infants, In Vivo
Condition: Fatty Acid Metabolism
Intervention:

41 Not yet recruiting Omega-3 Fatty Acids and Post Traumatic Stress Disorder (PTSD)
Condition: Posttraumatic Stress Disorder
Interventions: Drug: Omega-3 Fatty Acid; Drug: Placebo

42 Terminated Study of Dietary N-3 Fatty Acids in Patients With Retinitis Pigmentosa and Usher Syndrome
Conditions: Usher Syndrome; Retinitis Pigmentosa
Intervention:

43 Completed Supplementation of Phosphatidylserine (PS) and n-3 Long Chain Fatty Acids (EPA, DHA) in Children With ADHD
Condition: Attention-Deficit/Hyperactivity Disorder
Intervention: Drug: Phosphatidylserine-Omega3

44 Recruiting Taxoprexin® Treatment for Advanced Eye Melanoma
Condition: Metastatic Melanoma
Intervention: Drug: Taxoprexin

45 Active, not recruiting Taxoprexin Treatment for Advanced Skin Melanoma
Condition: Metastatic Melanoma
Intervention: Drug: Taxoprexin

46 Recruiting The Effects of Fish Oils on Blood Pressure, Heart Rate Variability and Liver Fat in the Polycystic Ovary Syndrome
Condition: Polycystic Ovary Syndrome
Interventions: Dietary Supplement: Ocean Nutrition EPAX-2050; Dietary Supplement: Olive oil capsules

47 Active, not recruiting Effect of Polyunsaturated Fatty Acids on Cardiovascular and Motor Responses Under Stress
Condition: Healthy
Interventions: Drug: Docosahexaenoic acid (DHA); Drug: Eicosapentaenoic acid

48 Recruiting Taxoprexin® Treatment for Advanced Primary Cancers of the Liver
Condition: Cancer of the Liver
Intervention: Drug: Taxoprexin

49 Completed Assessment of Feeding Tolerance in Infants Fed Cow Milk Formula
Condition: Healthy Term Infants Solely Formula Fed
Interventions: Other: Enfamil LIPIL with iron; Other: Good Start Supreme with DHA and ARA

50 Recruiting Effect of Supplemental Intake of Omega-3 Polyunsaturated Fatty Acids on the Rate and Complexity of Spontaneously Occurring Ventricular and Supraventricular Arrhythmias in Patients With Implantable Cardioverter Defibrillator (ICD) – A Randomized Clinical Trial.
Conditions: Coronary Artery Disease; Arrhythmia
Intervention: Drug: Eicosapentanoic acid (EPA) and Docosahexanoic acid (DHA).

[cosmik debris]

3. Wtf?

The OP said nothing about "Cannot be used to treat, diagnose nor cure any disease".

The OP is about anti-oxident vitamins.

Are you losing it?

[TZ]

5. heh.

Another Dr. Google there..They have no clue about science. Whats to try to impress us with their technobabble woo. Someone who has regularly posts things with technical terminology but really in scientifically inappropriate ways..I can sum up this post..I know MORE than any Doctor. I have read teh internets! I have a degree in internet experimental design!

[TZ]

4. Links?

You know, if you don't post your sources, this is no more than babble.
And you alties are big on funding sources aren't you? Who is sponsering these studies?
Some alternative treatments are studied and have merits, some are total bullshit and I'm sorry that we have to spend valuable money disproving bullshit. Amazing how much money is funneled into treatments that are nonsense just to satisfy the but you haven't tested MY magic pill crowd.

[mr blur]

6. Oh well, NOW I'm convinced.

I think you've missed the point.

[varkam]

7. There are an awful lot of words there that seem vaguely scientific, and somewhat related to the OP..

therefore, I agree with you. Also, poppycock is a funny word.

:crazy:

[LeftishBrit]

8. Many of your links seem to refer to Omega-3 fatty acids, which are not the same thing as antioxidant

vitamins.

Also, many of your quotes seem to refer to ongoing studies without final results.

Also, even if the antioxidant vitamins are useful in treating certain conditions, it doesn't mean that people should pop them regularly to prevent cancer. Antibiotics are useful in treating lots of conditions, but people should not pop them routinely.

[Warpy]

9. How many times do you need to be told

that the fact that studies are being done is no proof any of it will work? How many times will we have to define "preliminary research?"

[lizerdbits]

10. Until the world ends. NT

[Celebration]

11. I'm not exactly getting it--

Why is it a good idea to lump studies on different antioxidents together? Wouldn't it be like apples and oranges? Wouldn't this include something like betacarotene and also ascorbic acid? In the same "review"?

Actually there are different results on studies just with the various types of Vitamin E, and the various type of Vitamin C, so I am not even sure that those could be logically combined. And that's not to mention all the various dosages.

Let's just say I am unconvinced of the value of lumping studies of different substances with varying dosages all into one big review.

[Jim__]

12. Excellent point.

Someone who does research left a caveat in this forum recently:

... As a recommendation, I would never evaluate a study's methodological merit based on what you read in a newspaper. If you're really interested in evaluating its integrity, go to the original source. As someone whose research has shown up in the popular press, I can tell you that things get warped in the translation from academic journal to press release.

I found the summary of this study on Cochcrane's website and it supports your point. It appears they studied the various antioxidants separately:

Overall, the antioxidant supplements did not seem to reduce mortality. A total of 17880 of 136,023 participants (13.1%) randomised to antioxidant supplements and 10136 of 96527 participants (10.5%) randomised to placebo or no intervention died. In the analyses of the trials with low risk of bias, beta-carotene, vitamin A, and vitamin E significantly increased mortality. There were no significant differences between the effects of antioxidant supplements in healthy participants (primary prevention trials) or participants with various diseases (secondary prevention trials). Randomised trials with adequate bias control found no significant effect of vitamin C. In some of our analyses, selenium seems to reduce mortality.

The current evidence does not support the use of antioxidant supplements in the general population or in patients with certain diseases. The combined evidence suggests that additional research on antioxidant supplements is needed. The evidence on vitamin C and selenium was not conclusive. Future trials could focus on vitamin C and selenium and should assess both potential beneficial and harmful effects. Conduct of additional primary and secondary prevention trials on vitamin A, beta-carotene, and vitamin E seems questionable, at least in the dosage range examined.

To read the full study, you have to purchase it.

[semillama]

13. How dare you impugn the character of Cwiff Wichahds!!!!