This is post #120 on the site, about several biased, anti-supplement articles Dr. David Seres has written, published on the CNN website. The following information will debunk Dr. Seres’ claims and provide more accurate perspective and balance on his writings!
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Although I would rather spend time writing about breakthrough nutrition, health, aging and other topics, I’ve taken on some misguided doctors and researchers in recent posts. That’s because I’m sick of the personal attacks and misinformation these doctors spread, including attacks on supplements and alternative health based on little evidence or knowledge. I’ve seen this for decades! Supplement bashing is like a sport for many doctors and mass media.
Such is the case with Dr. David Seres, an MD who claims to have expertise in nutrition (he is apparently an associate professor of medicine and the director of Medical Nutrition at the Institute of Human Nutrition at Columbia University Medical Center).
Like many before him, his work demonstrates bias and ignorance about supplements and health: the broader history, science, safety, and significant micronutrient deficiencies (see links below). He largely ignores that vast content and positive research in favor of a few sensationalistic claims, based on a few bad actors. Then he adds some flawed, anti-supplement research to sound scientific. As you will soon see, his work is mostly theater and misinformation.
Some history
I first noticed the post Dr. Seres put up on Linkedin, when he jumped into the fray over that bogus testing done on a handful of herbs by the AG of NY (out of thousands of herbal formulas available). These stories were carried by the NY Times and other mass-media sources, hardly sources of credible science. Yet Dr. Seres embraced the pseudo-scientific reporting and used it as the genesis of his article (see quotes and links below).
For some perspective, I knew that the DNA barcode testing for finished herbs was bogus in 2013, because I debunked the unproven method along with other junk, anti-supplement studies the media went wild for in late 2013 (as they often do).
My initial response to Dr. Seres’ Linkedin thread included many links that explained why the DNA testing for herbs was not scientifically valid, showing that the DNA barcode method is both flawed and unreliable for most finished herbal supplements (it might work better on raw ingredients but even that use is not yet validated).
People seem to assume that any test that sounds scientific should work (too much pop-culture science, I guess). In reality, no credible system of testing is done based on mere assumptions, although there are many tests that ARE already used and validated for herbs. but those tests weren’t used by the AG of NY (see links below).
Here is a link to that 2013 post where I debunked several mass-media anti-supplement stories, including the DNA herb testing (I also included this link in my Linkedin comment in response to Dr. Seres). The third section is focused on the DNA herb testing but all the content is relevant to how the media and people like Dr. Seres publish biased writing, often filled with wild, unfounded claims:
http://www.endsicknessnow.com/anti-vitamin-propaganda
Dr. Seres seemed happy to capitalize on this new story about the herb testing done by the AG of NY, including the subsequent media sensationalism that ensued. Perhaps he wanted to leverage his way into the media antics and buzz that swept most media sources, most of whom are scientifically ignorant (most reporters have no science, nutrition or health background; they simply work off a 1-2 page press release, designed to maximize media coverage).
So indeed, Dr. Seres added his dramatic-sounding piece about supplement fraud and dangers, typical in tone and structure that someone who has little actual education or background in micronutrients, testing, or manufacturing. It’s called, The potential danger of dietary supplements. I guess we all need to lock our doors at night, vitamins and supplements are gonna get us!
For me, his article exposes his glaring bias against supplements, as it’s filled with overly-broad, questionable claims that supplements are unregulated, unproven and even dangerous (the FDA does regulate many aspects of supplement manufacturing, including claims, advertising, labeling and consumer safety reporting, see detailed links below). These sweeping claims made by doctors and the media are mostly false, usually based on a small handful of examples.
And Dr. Seres apparently knows or cares little about the decades of shocking and widespread fraud behind drugs and drug research: from biased, manipulated studies, to exaggerated benefits, hidden studies and side-effects, behind-the-scenes cash to influence research and study authorship, drug money for “medical education,” doctors put on drug company boards, fake diseases invented by drug companies to sell more drugs (Osteopenia, OAB, Restless Leg Syndrome, Low T), etc.
The corruption in medicine is a far more common and dangerous problem than a few bad supplements or companies. Those pervasive medical problems have been exposed by credible medical experts, all covered in my post called, 5 big Medical Lies, with over 100 expert quotes and 200 source links. Here are a few relevant links (of hundreds I could put up):
http://www.endsicknessnow.com/5-big-medical-lies
http://www.naturalnews.com/023127_drug_doctor_doctors.html
http://www.naturalnews.com/048915_FDA_science_fraud_false_information.html
http://www.orthomolecular.org/resources/omns/v04n20.shtml
http://www.orthomolecular.org/resources/omns/v05n02.shtml
http://pharmamkting.blogspot.com/2009/04/overactive-bladder-pharmacia.html
http://www.kevinmd.com/blog/2011/01/create-disease-market-drug.html
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm436280.htm?source=govdelivery
Dr. Seres exemplifies the anti-supplement/pro-drug position, as he follows the classic recipe for writing overblown, mass-media articles: dig up a few anti-supplement stories that sound dramatic (but skip important details, context or balance), then spice it up with sweeping claims and name calling (using the term “quackery” is guaranteed to get a reaction), and finish strong with your act 3 finale: toss in a few anti-supplement studies to sound scientific (even though the biased, flawed studies were debunked years ago).
Nicely done Dr. Seres! Like magic, you’ve created some biased, overblown works, embraced by the hacks at CNN in their endless pandering for ratings and website clicks and viewers. And surprise! This all took place during a sweeps period (from January 29-February 25, 2015), when the NY Times and Dr. Sears got his new piece up on CNN! It’s exciting isn’t it?
Sweeps and theatrics
This is a common situation for many anti-supplement studies and articles. The Nielsen sweeps calendar is set well in advance, so all the national and local stations, medical journals and writers can ratchet up their stories and hype to increase exposure. Have you noticed? A sudden wave of hyped-up stories are produced and written, designed to boost ratings and ad revenue. It’s done that way all the time. This Dr. Seres post carried by CNN is a perfect example. TV outlets often use their website content to leverage online content to attract more viewers. Local and national programs pitch their web content constantly.
In fact, watch for major sweeps (and overblown stories) centered around 4 months every year: February, May, July and November, with each period encompassing a rotation of shows (spring fill-in shows, season finale’s, summer replacements and new fall shows). Sweeps are the basis of network and station viewership and ad rates, so they routinely pump up their often predictable stories with more overly-dramatic story lines and promotions: special guests, investigations with dark storylines, heavy promotions, etc. Otherwise, it’s crime, carnage, kids, critters, controversy and corruption.
And yes, newspapers have a similar system for measuring circulation, so these sweeps periods are often exploited by all media in a “me too” approach. In reality, you’re just a pawn in their plan to boost ratings, circulation and ad rates. It’s all about the media and their income (here are a few links):
http://www.tvjobs.com/sweeps.htm
http://www.frankwbaker.com/sweeps.htm
The following link is a debunking of another sensationalistic, anti-supplement article, using a similar formula to the one Dr. Seres used. It’s equally biased and distorted (and ironically, it relies on some of the same junk studies Dr. Seres mentioned). I debunk the article and studies in the link, and I think I included this link in my Linkedin comments to Dr. Seres as well:
http://www.endsicknessnow.com/propaganda-the-dark-side-of-ignorance
Dr. Seres also seems to be a gullible believer in the media coverage and junk studies he mentioned, and therefore, he easily overlooks the lack of common sense, rational thinking and major flaws in those studies (see many pages of details, author quotes and links below).
Dr. Seres posts on Linkedin
Here are some of his opening paragraphs in his CNN article he used in his Linkedin post:
There was some good news this week. The New York state attorney general’s office has told four major retailers –Walmart, GNC, Target and Walgreens — to cease sales of their store-branded herbal supplements because their products do not actually contain the herbs purportedly listed on their labels. These herbal supplements contain mostly fillers and in some cases potential allergens. But other supplements are more worrisome.
As a nutrition expert, I am horrified by the daily barrage of outrageous and unsubstantiated claims touting cures from everything from E. coli to Ebola. If you do a Web search on just about any disease, you will find carefully worded ads promoting unproven nutritional therapies. Worse, some of these can be harmful. For example, people have suffered liver damage from green tea extract that is so severe that they have needed a liver transplant. And the frequency of harm from dietary supplements is on the rise.
I will soon provide some serious debunking for his dramatic, opening claims. First, I’ve noticed that although he claims to be a nutrition expert, he doesn’t seem to write about the health benefits of good nutrition or offer positive nutritional advice. Instead, both of his articles on CNN (and the related comments and summaries I’ve seen) are focused on nutritional fear-mongering and anti-supplement articles using the predictable writing formula I mentioned above.
His approach, also used by other mass-media outlets, is that a few questionable supplement companies and some dramatic claims prove the rule! It’s a perfect recipe to attack thousands of honest and ethical supplement companies and their products in a few, quick paragraphs, based on the irrational “the exception proves the rule” construct. Most educated, thoughtful adults know better: it’s a false premise (the exceptions DO NOT prove the rule, that’s why they are exceptions)!
My initial response to his post (which he never addressed):
Although the CNN opinion article made some valid points [I wanted to be nice], it is also highly biased, taking a few isolated examples and generalizing well beyond those examples. That’s not scientific, nor is the basis of that herb testing (see links below).
What’s more, supplement manufactures are quite heavily regulated by the FDA now (hundreds and hundreds of pages of regulations, covering all areas of manufacturing, testing, packaging, labeling, record-keeping, warehousing, distribution, adverse-event reporting, etc.)
Unfortunately, the media loves to report these biased types of stories, as they get us all reacting, all the while saying nothing about the millions of deaths and injuries that prescription drugs, medical errors, and medical misdiagnosis cause annually (costing tens of billions for extra treatment).
As for the recent news about claimed herbal adulteration and fraud, here are some insightful articles and debunkings for the flawed, unreliable testing used and other info:
http://newhope360.com/breaking-news/ahp-sends-58-page-response-new-york-ag
http://newhope360.com/news/fda-called-test-used-new-york-ag-invalid-year-recall
http://www.anh-usa.org/new-york-ag%E2%80%99s-supplement-test-completely-contradicted-by-new-research/
http://www.prnewswire.com/news-releases/abc-says-new-york-attorney-general-misused-dna-testing-for-herbal-supplements-300030463.html
http://cms.herbalgram.org/heg/volume10/11November/DNAbarcodingReviewandCritique.html?t=1383684796&ts=1385136893&signature=ca334b1ff0a93f9d87a74ef7274be1ab&ts=1423063597&signature=6307a373b7a2d1a3e8e8088b531673ec
I’m guessing that many here may be unaware of how much regulation there is for supplements these days as the myths of an unregulated industry persist.
Feel free to review all of these FDA links/subcategories which include dozens of links and many hundreds of pages of regulations, requirements, practices and policies for supplements, covering all the steps I mentioned earlier:
http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/DietarySupplements/default.htm
Medical practitioners often claim that supplements are “unregulated” which is a false claim and simply a way to attack supplements (ironic as most doctors had no substantial education in nutrition or supplements). The media loves these myths too because it’s quick and easy sensationalism!
One problem with these stories and reports is the lack of perspective! Here is another link about those medical issues and about how little of medicine is actually evidence-based or proven (with lots of source links at the end):
http://www.endsicknessnow.com/medicine-and-pseudoscience-new-insights
And this article has even more insights and a whole series of additional links to newer debunkings of that bogus DNA herb testing:
http://www.ahpa.org/Default.aspx?tabid=507
For the record, Dr. Seres offered no links or important details like patient numbers or dosages regarding liver damage; no credible details to support for his claims of harm from green tea extract (many were actually weight-loss supplements with multiple ingredients). No matter! Green tea extract was simply assumed to be the cause, even as he ignores the far bigger cause of liver damage: drugs (more details and debunking below).
In addition, he didn’t mention that people apparently took more than the recommended dosage, he didn’t look into what other supplements or drugs they ingested, he didn’t outline their overall health or liver status before taking the supplements, he didn’t look for how much they drink (alcohol and drugs and both be hard on the liver), etc.
In other words, Dr. Seres wasn’t very scientific at all; he took the biased NY Times article at face value and seemed unconcerned about any of those pesky details/confounding factors (things he would insist on if a patient of his died from a suspected prescription drug).
Plus, he apparently buys into the standard media narrative that individuals are victims of supplements, even when they exceed recommended dosages or engage in other risky behavior by combining supplements, drugs, alcohol, etc. Let’s demonize the supplements instead! In short, his articles are long on dramatic claims and hype, but short on crucial facts, details or science: classic bias!
Medical people and the government are often quick to blame supplements whenever they can, even when these claims are simply assumed (and unproven), or when the end user is abusing themselves and going overboard by exceeding recommended intakes, supplements are routinely blamed as the cause, not the individual’s choices or behavior! See how that’s done? People who make bad choices are still the victims of supplements!
It’s a 24/7/365 campaign that I’ve watch for 20 years and the media loves, loves to attack supplements and glorify drugs (which helps to bring all those drug ads with all that awesome revenue)!
Shocking reality: drugs vs. supplements
I bet you didn’t know that drugs kill at least 115,000-120,000 people annually (when taken as directed, based on FDA reports). Some estimates range up to 140,000 annually (it’s often hard to prove which drug or combination killed someone, especially when they are taking several per day).
Compare that number to supplements, which have apparently killed zero (0) people in 30 years, based on over 50 U.S. Poison Control reports. In other words, over about 30 years of reporting, total drug deaths are about 3 million people in the U.S., while dietary supplements have apparently caused NO deaths (even at well-over 60 billion doses annually). Drugs also cause annual adverse reactions at a shocking high rate compared to supplements: Serious adverse events from drugs are approaching 400:1 compared to supplements (see more details and FDA links below), even for similar annual consumption of supplements and drugs.
For example, we consume at least 60-billion individual supplement doses annually, probably closer to 120 billion for those taking 2 or more supplements daily. That would be about 2-4 billion bottles (an average 30 or 60 tabs or capsules per bottle). Compare that usage to about 4 billion annual prescriptions for drugs (with varying amounts of pills for each prescription).
Here are several links to articles about the U.S. Poison Control reports on supplement safety:
http://www.sott.net/article/201498-No-Deaths-from-Vitamins-Minerals-Amino-Acids-or-Herbs-Poison-Control-Statistics-Prove-Supplements-Safety
http://www.sott.net/article/236212-27-Years-No-Deaths-from-Vitamins-3-Million-from-Prescription-Drugs
http://www.orthomolecular.org/resources/omns/v11n01.shtml
So with consumption for supplements and drugs in the same ballpark (say 3-4 billion bottles annually), drugs cause adverse events at a rate of about 375:1 (and rising fast), meaning that for every supplement adverse report (often unproven that the supplement was to blame), there are about 375 for drugs (additional details and links below).
BTW, the annual costs for drugs run about 10X what they are for supplements: about $30 billion for supplements (which many people claim is shocking), vs. over $300 billion for drugs (which is apparently okay if you make money off drugs or drug ads?), and something no one seems to notice and the media almost never mentions!
Do you begin to see how medical doctors and the media mislead you with these stories every day, filled with bias, manipulation and exaggeration? These statistics expose the deep bias, manipulation and double standards for media and medical reporting (it’s okay if we do it, but it’s not okay if you do it)!
So Dr. Seres, if you see this post, why do you show so little concern or outrage over the millions of documented deaths and injuries from prescription drugs? Why aren’t you writing about those far more serious and growing issues, along with all the fraud and corruption in your own field of medicine? Are you in a state of deep denial?
You’ve apparently never written about those issues, preferring to focus your overly dramatic, exaggerated, even unfounded claims against supplements only. Apparently, sweeping and dangerous medical corruption, along with millions of drug deaths and injuries are okay, while a few supplement problems are shocking? Isn’t that rather misguided!
Blame supplements for liver damage?
BTW, in his biased CNN article, Dr. Seres mentioned those vague cases of liver damage I touched on above, implying they were only for green tea extract (but those were often in weight loss pills with multiple ingredients, something I never recommend anyway), and his claims were apparently based on a handful of cases covered in that highly slanted, NY Times story. As I said above, many people apparently exceeded the recommended dosages (again, the media loves to blame the supplement, not the user, even when they exceed the recommended usage)!
But wait! Most of the cases of liver damage (about 80%) were left out of the NY Times article. They are caused by drugs, including OTC drugs like Acetaminophen, antibiotics and other drugs. It’s amazing that Dr. Seres didn’t seem to notice the missing 80% of cases in the NY Times article! Not a word about all the drugs that cause liver damage in his biased anti-supplement article. And he seems not to care about OTC drugs, which have caused serious health problems for years (pain pills, pseudoephedrine, antacids, etc.). Again, more blatant bias, more pot calling the kettle black!
In fact, here are 2 quotes from similar studies that arrive at similar conclusions, showing most liver damage is from drugs (but with more details), providing a more accurate perspective then the manipulative NY Times article Dr. Seres relied on, covering several years and population groups (see Science Daily links below):
Among the 5,484,224 patients evaluated, 62 were identified with acute liver failure, nearly half of which were [OTC] drug-induced. Acetaminophen was implicated in 56 percent of cases, dietary/herbal supplements in 19 percent, antibiotics in 6 percent and miscellaneous medications in 18 percent [totals 80% for drugs, 19% for supplements].
Researchers identified 61 different agents that, alone or in combination, could cause liver injury and failure in the study population. Anti-microbial agents [like antibiotics and antifungals] were found to be the most common cause of DILI [drug-induced liver injury] ALF [acute liver failure] cases and included anti-tuberculosis drugs (25), sulphur-containing drugs (12), nitrofurantoin (12), other antibiotics (7), antifungal agents (6), and anti-retroviral drugs (4). Patients who develop ALF after taking these drugs typically do not experience a spontaneous recovery — the transplant-free survival rate in this study was 27%.
Can you see that Dr. Seres didn’t mention the missing 80% of cases that caused liver injuries or that they were caused by drugs? Yes, the vast majority of cases of liver damage comes from drugs, both prescription and OTC. He just skipped that part, preferring to play up the 19-20% that were claimed (but not proven) on supplements over several years. BTW, Dr. Seres should list all the tests that can prove that supplements caused liver damage (because it’s often inferred but not proven, often ignoring other confounders).
Is it ever more clear that his bias blinds him to objective reality? Is his information balanced or accurate? Or is his article a source of misinformation and propaganda (slanted, targeting the emotions, supporting a political cause, shaping beliefs, etc.)? The answer is obvious!
With the millions of injuries and deaths from drugs, including liver damage/failure, they are clearly the more urgent problem. Do you find it troubling that Dr. Seres (and most other doctors), as well as the ignorant mass media constantly bash vitamins and supplements as the bogeyman, even as they ignore the real carnage and suffering from drugs and medical procedures that occur under their noses?
The following article offers some very credible debunking of Dr. Seres and the NY Times bold claims for liver damage from the overblown and inaccurate article he referenced in his info (written by the same attention-seeking, biased and grandstanding reporter who wrote the bogus herb testing article, and who appears to have no relevant background in science, medicine or nutrition to write these articles):
http://www.naturalproductsinsider.com/blogs/global-evolutions/2013/12/despite-new-york-times-warning-liver-damage-from.aspx
That article link indicates that cases of liver damage from green tea are rare, and that there were non-significant issues with liver damage with proper use. The article also shows that a proposed caution for labeling green tea extracts was withdrawn before being enacted because a proven connection between green tea extract and liver damage was NOT found:
USP later reversed its recommendation of label warning because it could not find a direct risk between green tea extract and liver damage after it continued its research, according to Claudia Costabile, USP’s PR manager.
This link and article also indicates that cases of liver damage or elevated enzymes from green tea extract are very rare (it’s sad that all these pesky details and realities get in the way of Dr. Seres biased, exaggerated claims):
http://www.drweil.com/drw/u/QAA400328/Supplements-and-Liver-Damage.html
Links showing many of the critical details omitted from the Dr. Seres’ article regarding the common sources of liver injuries:
http://www.sciencedaily.com/releases/2015/03/150303153226.htm
http://www.sciencedaily.com/releases/2010/11/101130122037.htm
So again, do you see the sloppiness and lack of credibility in Dr. Seres’ work and how his dramatic claims are significantly undercut? Apparently, critical details, balance and perspective are not important in his writings.
More on Dr. Seres’ CNN article
These telling quotes from the end of Dr. Seres’ CNN anti-supplement article continue to reveal his strong anti-supplement bias and penchant for theatrics and dramatics, citing just 2 debunked, anti-supplement studies and extrapolating way beyond those weak examples to claim supplements cause harm time and time again):
The authors and supporters of nutritional quackery are often quick to claim that there is little potential harm. After all, we are talking about nutrients. We all need nutrients, so of course they are safe, right? The magical thinking that nutrients or herbs that we take into our bodies have no potential for harm often goes unchallenged. But we have seen time and again that nutritional interventions that sound great can turn out to be harmful. For example, in large randomized trials, beta carotene increases the incidence of lung cancer. In other studies, vitamin E and selenium significantly increased the incidence of prostate cancer.
Nutritional science is very complex. If these substances are effective, they are acting as drugs and should be regulated as such. Given the clear potential for harm, and even death, from these unregulated supplements, and the lack of ethics in the absence of strong prohibitions, it is time for better laws. But meanwhile, let the buyers beware.
These Dr. Seres quotes are again telling, filled to the brim with bold claims, fear mongering and dramatic language (much of this content appears to be borrowed from the Dr. Offit school of extreme anti-supplement bias). As usual, Dr. Seres is short on credible scientific detail, nuance or accuracy (I will debunk his overblown claims for the outdated Finnish Smoker’s study and the SELECT trial below).
First, notice the second paragraph and how Dr. Seres conflates supplements and drugs because they both can have effects. This from a doctor who claims to be a nutritional expert? Really?
Because supplements, especially nutritionally-oriented ones like vitamins, minerals, amino-acids, anti-oxidants, fish oil/omega-3s and others, work by providing nutritional support for the body to achieve optimum nutritional health.
Drugs? Drugs often work by disrupting normal physiology (which is why you get so many side effects from drugs). Drugs generally treat symptoms and most do not nourish, cure or restore health. Many drugs are designed to create dependency and cash flow for drug companies but cure. . .nothing! Only your body can do that!
In short, supplements and drugs work on very different principals and generally behave very differently in the body (especially when supplements are taken as suggested). But like most doctors, his bias is sweeping and simplistic: supplements are bad, drugs are good, when the exact opposite is often true for many areas of health, safety and cost!
In truth, both articles Dr. Seres wrote for CNN are little more than supplement bashing; neither provides credible balance, perspective or important details (the liver damage claims are just one example). He also omits the documented benefits of micronutrients, ignoring thousands of studies that show the health benefits of individualized optimum nutrition, including vitamins, minerals, anti-oxidants, and other phytonutrients. Again, this extreme level of bias and distortion from a “nutrition expert?”
This link covers a range of recent anti-supplement studies, including common ways used to show failure, and how media campaigns are planned to maximize coverage:
http://www.endsicknessnow.com/anti-vitamin-propaganda
Additional details for side effects: supplements vs. drugs
As I mentioned above, here are some additional details comparing side effects for supplements and drugs. According to the FDA’s own tracking for supplements and drugs, there were just over 3,000 assumed (but unproven) supplement reports in 2013 compared to about 1,780,000 for drugs in 2013 (2.26 million in 2012 and 2013). That’s not a typo, the reported serious adverse events for drugs are over 1.75 million events annually and rising quickly (up over 50% in just the last few years).
If you do the math, it’s about 375 prescription drug adverse reports for each single report for supplements in 2013. This comparison for safety is not even close! The real dangers (deaths, injuries, suffering, billions in extra treatment, etc.) are caused by drugs, not supplements, with drugs 375 times more likely to cause a serious adverse event. Yet he is focused exclusively on supplements as the real sources of harm?
Again, remember that there have been to no reported or proven deaths from supplements in almost 30 years but 3 million for prescription drugs over the same period. Is that enough bias and distortion for you? Have you ever seen a mass-media story about this level of carnage? Here are some important links with more details (scroll down to see both graphs and charts):
http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/ucm070434.htm
Deaths and serious injuries reported to the FDA 2004-2013:
http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/ucm070461.htm
http://www.naturalproductsinsider.com/news/2014/04/dietary-supplement-adverse-event-reports-increase.aspx
Here is a link about overall drug spending in 2013:
http://thinkprogress.org/health/2013/05/10/1993841/prescription-drug-spending-drops/
More junk science from by Dr. Seres
Now here are those debunking links I promised for the studies Dr. Seres mentioned in his CNN articles (the Finnish smoker’s study and the SELECT study).
For his act 3, Dr. Seres built his flimsy case against supplements on weak, biased studies that don’t really prove what he claims. Dr. Seres, science is a process! It’s takes multiple, independent study replications (not by the same researchers or cancer organization) with large numbers of human subjects over a long time, using credible, meticulous study design and analysis before the findings can be relied upon.
There are many studies showing benefits for supplements like beta-carotene (a precursor to vitamin A), vitamin E and selenium, which Dr. Seres never mentions in his articles! So until there are sufficient studies that replicate the questionable studies you cite (again you seem to be a follower of the highly biased work of Dr. Offit), your examples are weak and they have been debunked for their significant bias and flaws years ago! Seems like you don’t follow the process of science at all!
You want us to believe that a beta-carotene supplement (think of the antioxidant amount found in a few carrots eaten daily) increases lung cancer in older, life-long, heavy smokes? Really?
Dr. Seres’ logic is that life-long smokers didn’t get cancer from over 35 years of smoking (and probably other bad lifestyle choices), they got cancer from taking an anti-oxidant supplement that had the beta-carotene of a few carrots, taken for a few years of a research study. This is an irrational premise at it’s core. Cancer takes decades to materialize in most subjects. But in his simplistic, reductionist view, beta-carotene is a killer? Where is the intelligence in all this? Left at the door?
The Finish Smoker’s (also called the ATBC study) is from 1994 (but it started way back in 1985, 30 years ago), and yes, it used subjects in Finland. The subjects were older males (average age 57), life-long smokers (over 35 years), averaging 20 cigarettes/day, plus being drinkers (and I bet the alcohol consumption was severely under-reported). The actual outcome in the subjects was less than a 1% difference in cancer rates, a meaningless outcome by any measure, and one likely due to chance, based on the authors own statements.
First, here are 4 quotes and 3 links to sites that debunk key parts of the Finnish Smoker’s study, outlining the kinds of bias, poor methods and lack of common sense I mentioned above. The initial quotes are from the first link below and include the use of exaggerated numbers (Relative Risk) and statistical manipulation to boost the findings for media coverage and buzz (which Dr. Seres apparently finds credible and compelling. Link below quote):
The public was simply misled by the media in their reporting of the NCI study involving long-term Finnish smokers. The news reports sounded like they were saying that smokers should stop taking vitamin pills because they were potentially more dangerous than cigarettes!
NCI’s study suggested that there was an 18% greater incidence of lung cancer deaths among Finnish smokers given beta-carotene as compared to those given placebo. This is statistical gibberish. The absolute difference between each group of 7,287 participants receiving beta-carotene or placebo was actually 0.00548%, or one-half of one percent, not 18%. There were 262 deaths among 7,287 non-beta-carotene users (3.596%) and 302 deaths among 7,287 beta-carotene users (4.144%). These are real numbers, not relative numbers, and they indicate that there was no more than an absolute difference of 0.00548%, or one-half of one percent, not 18%, in mortality rate.
The NCI researchers must have realized this insignificant difference. They stated in their paper:
“…there are no known or described mechanisms of toxic effects of beta-carotene, no data from studies in animals suggesting beta-carotene toxicity, and no evidence of serious toxic effects of this substance in humans. In light of all the data available, an adverse effect of beta-carotene seems unlikely, therefore, this finding may well be due to chance.”
In recent years, the media has had a disturbing tendency to mislead the public regarding “risks” associated with dietary supplements and improvements in the diet, by highlighting contrary and atypical findings. Two years ago the hypothesis that iron may increase the risk of coronary heart disease was based on a Finnish study that was widely reported by the media, even though scores of earlier studies had not found such an association. Two years later several large studies in the same New England Journal of Medicine, reported finding no association between iron and coronary heart disease, but not before millions of Americans worried needlessly about taking iron supplements or eating foods rich in iron.
http://www.encognitive.com/node/13059
Here is another link that debunks the study, especially for the beta-carotene:
http://honestnutrition.blogspot.com/2006/07/beta-carotene-risks-proven-false.html
The following study link shows that a mix of anti-oxidants, including beta-carotene, accurately predicted LOWER cancer risk for higher intakes of anti-oxidants in the same study subjects, along with better tracking of confounders (showing a significant and common flaw in the study design, because isolated forms of nutrients are less effective (only 1 form of beta-carotene was used in the smoker’s study) instead of the broader family of carotenoids:
http://aje.oxfordjournals.org/content/156/6/536.full
Remember that nutrients don’t work well in isolation (they are NOT drugs). Vitamins, minerals and anti-oxidants, and other nutrients work synergistically, and with food and lifestyle/health status, including beta-carotene and vitamin E.
So being life-long, heavy smokers (the beta-carotene group smoked the longest at 37 years) didn’t cause more cancer but the beta-carotene amount found in a few carrots/day, taken for a few years did? Again, the premise doesn’t pass the smell test; the lack of rational thought is mind-numbing!
Here are several key quotes from the Discussion section of the full ATBC/Finnish Smoker’s study (the second quote is similar to the quote above). I predict that Dr. Seres never read the whole study because, as I mentioned earlier, its very premise strains credulity and reason (when older, life-long, heavy smokers got lung cancer, the supplements are blamed for increased cancer even though they were only taken for a few years (citation numbers removed, see full study link below):
It is plausible that the intervention period was too short to inhibit the development of cancers resulting from a lifetime of exposure to cigarette smoke and other carcinogens. Beta carotene may not be the active cancer-inhibiting component of the fruits and vegetables identified as protective in observational studies, or the intake of beta carotene may be only a nonspecific marker for lifestyles that protect against cancer. Although it is conceivable that the dose we used was too low, this seems unlikely, since that dose exceeded by many times the dietary intake of beta carotene in epidemiologic studies that found a strong inverse association between the consumption of carotene-rich foods and the incidence of lung cancer. Finally, study findings regarded as showing supplementation to be beneficial or harmful may occur by chance.
Our results raise the possibility [but not a certainty] that supplementation with beta carotene may be harmful in smokers. The higher mortality due to ischemic heart disease and lung cancer among the beta carotene recipients requires more detailed analysis, and information from other studies is also needed [I predict a connection here].
We are aware of no other data at this time, however, that suggest harmful effects of beta carotene, whereas there are data indicating benefit. Furthermore, there are no known or described mechanisms of toxic effects of beta carotene, no data from studies in animals suggesting beta carotene toxicity, and no evidence of serious toxic effects of this substance in humans. In the light of all the data available, an adverse effect of beta carotene seems unlikely; in spite of its formal statistical significance, therefore, this finding may well be due to chance.
In summary, we found no overall reduction in the incidence of lung cancer or in mortality due to this disease among male smokers who received dietary supplementation with alpha-tocopherol, beta carotene, or both in this large trial in Finland. The results of this study raise the possibility that these substances may have harmful as well as beneficial effects. Longer observation of the participants in this trial and data from other studies of people at normal risk or high risk for cancer will be required to determine the full spectrum of effects of these agents. Public health recommendations about supplementation with these micronutrients would be premature at this time.
http://www.nejm.org/doi/full/10.1056/NEJM199404143301501#t=article
The study authors openly acknowledged that their study had significant limitations, saying that adverse or toxic effects or mechanisms of beta-carotene seemed unlikely. They also reference other beta-carotene studies that found anti-cancer benefits. They don’t support Dr. Seres’ overblown, overly-dramatic and unproven claim from the CNN article:
For example, in large randomized trials, beta carotene increases the incidence of lung cancer.
But compare Dr. Seres proclamation to the short Conclusion from the trial authors, outlining far more modest outcomes (see study link below):
We found no reduction in the incidence of lung cancer among male smokers after five to eight years of dietary supplementation with alpha-tocopherol or beta carotene.
The authors expressed significant uncertainty about their own study findings, yet Dr. Seres proclaims that beta-carotene increases the incidence of lung cancer without any qualification? When it comes to research, his penchant for dramatic, anti-supplement headlines leads him embrace exaggerated, even unfounded claims (like most doctors), especially from mass media and journal-marketing departments. This is a pattern I’ve seen for many years, and in fact, most doctors are research amateurs. They often trust the medical journal who publishes the study, but don’t bother to read and analyze the entire study themselves, including design, analysis, charts, graphs, limitations, etc.
In short, Dr. Seres demonstrates an obvious lack of research savvy: Not only does he embrace overblown, mass-media reporting, he skims the surface of research studies, missing obvious flaws and critical details. I doubt that he reads and carefully analyses the anti-supplement studies he trumpets: subject characteristics, design, possible confounders, charts, graphs, tables, footnotes, data analysis, limitations,, disclaimers, positive outcomes, etc. Ironically, that’s where the real story (and truth) is often found!
After reading all the quotes and details I have provided for the smoker’s study, do you still believe Dr. Seres’ bold, unconditional statement?
Sadly, Dr. Seres has probably mentioned these studies on other occasions, such as anti-supplement discussions, talks and writings. It’s likely that he has spread this misinformation to other people. Remember how he ignored the pesky reality that 80% of liver damage was actually caused by prescription drugs, preferring to focus on green tea as the real (but unproven) evil? Yep, that’s what bias and a disregard for scientific truth does.
Remember, Dr. Seres is a professor! I wonder how many young minds he has corrupted over the years? I wonder how many students have heard his biased, simplistic, anti-supplement views and anti-supplement research claims, corrupting another generation with misinformation! It’s recklessness, not science!
SELECT trial: more bad science
But there’s more! The original SELECT study on selenium and vitamin E has also been discredited for its obvious bias, poor methodology and exaggerated claims (remember that there are many other studies that show positive benefits for vitamin E, especially more balanced forms). And in SELECT, the actual risk of prostate was under 1%, but exaggerated with Relative Risk to pump up small findings into much larger numbers, common in drug and anti-supplement research. SELECT is a very similar situation to the smoker’s study I just debunked.
For example, it’s known by many nutritional experts (unlike most doctors and researchers), that isolating nutrients like a vitamin or mineral and placing them in the role of a drug is often doomed to fail, especially with high-risk or sick patients. As I said above, nutrients work synergistically, with food, lifestyle and other factors. They don’t work well in isolation, something a proclaimed “nutrition expert” doesn’t know?
SELECT also used older males (some over 75), many were former smokers, the allowable PSA was high (healthy levels are 1-3 ng/mL), and the authors didn’t have good tracking of critical lifestyle confounders like diet, exercise, alcohol intake, genetics, etc., factors that are known to contribute to cancer development. Again, cancer is a multi-factorial, long-term disease, and prostate cancer is especially slow growing for most men (see link after SELECT links below).
And know this: If this was a study with the same subjects based on some drugs, and it got these results, the study would never have been published! Drug company files are filled with unpublished studies that brought null or negative results; they’ve been hidden them away for years! Also, which drug prevents prostate cancer without side effects again? There are none, that’s how many there are! Again, before we even pick the study apart, do you see the double standards and obvious bias at every step? Are you seeing this Dr. Seres?
This is also critical: various forms of nutrients also have differing bioavailability and effectiveness. Natural vitamin E has 8 different forms (something Dr. Seres never mentions and seems not to know or care about), similar to vitamin B and its multiple forms. The forms of vitamin E need to be ingested in relative balance, as a high dose of one form might compete with other forms or disrupt the efficacy of others (the alpha, delta and gamma forms of vitamin E are known to interact this way). Dosages can also be too high or too low (in SELECT, the synthetic alpha-tocopherol vitamin E dose was very high at 400 IU per day, normal intake is closer to 20-30 IU/day). These are but a few reasons why studies like SELECT, on high risk or sick people might seem to fail.
These links may offer some insights on forms of vitamin E and their health and cancer benefits (I could put up many more but the debunking links overlap this info):
http://www.lef.org/Magazine/2011/1/Critical-Importance-of-Gamma-E-Tocopherol-Continues-to-Be-Overlooked/Page-01
And here are some important quotes from the link below, including positive results for vitamin E and selenium in large studies, and some additional insights for why the synthetic alpha-form of vitamin E might not have worked in previous trials against cancer (for some reason, Dr. Seres doesn’t seem to mention these relevant studies, again showing his bias and slanted viewpoint):
Let’s return to the Johns Hopkins study mentioned earlier. A total of 10,456 men participated in the trial, in which researchers compared alpha-tocopherol, gamma-tocopherol, and selenium. They found that men who had the highest blood levels of gamma-tocopherol were five times less likely to get prostate cancer. Another important finding was that alpha-tocopherol and selenium protected against prostate cancer only when gamma-tocopherol intake was high. That means the alpha- and gamma-tocopherols have a synergistic effect when it comes to prostate cancer.
Then there was a review published in “Carcinogenesis” in 2010 in which the authors explained how many large-scale studies with alpha-tocopherol had not shown anti-cancer benefits. The authors suggested this lack of effect was caused by high doses of alpha-tocopherol, which reduced the body’s levels of delta-tocopherols. They also noted that gamma-tocopherol had “strong anti-inflammatory” properties and that it “may be the more effective form of vitamin E in cancer prevention.” They concluded by saying, “we propose that a gamma-tocopherol-rich mixture of tocopherols is a very promising cancer-preventive agent and warrants extensive future research.”
Yet another study indicated that gamma-tocopherol can help protect against development of prostate cancer. From a total of approximately 20,000 men who donated blood samples for analysis of micronutrients and prostate cancer risk, the investigators found “potential chemopreventive effects of gamma-tocopherol on prostate cancer” and a weak association between alpha-tocopherol and prostate cancer risk.
http://www.huffingtonpost.com/craig-cooper/vitamine-e-prostate-cancer-_b_1016922.html
Link is to the full 2010 review study in Carcinogenesis quoted above, with a detailed analysis of various forms of vitamin E, their interaction in human and animal studies, and cancer prevention (something a “nutrition expert” should already know):
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860705/
Adding to that information, these important quotes from authors of the SELECT trial, covering critical limitations that Dr. Seres again seemed to skip in his rush to demonize vitamin E. Like the smoker’s study authors, these authors raise significant concerns about the design, dosages and other confounders in SELECT that could explain or skew the results.
In fact, these comments mirror the concerns raised by many debunkers, some of which Dr. Seres baselessly attacked in his article when he claimed that proponents of supplements used outlandish theories to deny the findings! Really Dr. Seres? Did you not know that the SELECT authors raised similar concerns and important limitations, including some benefits for vitamin E (Note: citation numbers removed to avoid confusion, first paragraph broken up for easier reading. See link below):
There are potential reasons why vitamin E did not prevent prostate cancer in SELECT. First, the high dose (400 IU/d) of the a-tocopherol form of vitamin E in SELECT may have been less effective than a lower dose such as the 8-fold lower 50 mg/d (roughly equivalent to 50 IU/d) that produced the earlier positive secondary findings in the ATBC study. (The vitamin E formulation, synthetic all rac-a-tocopheryl acetate, was the same in SELECT and the ATBC study.) A secondary analysis of the HOPE trial23 found that a relatively high dose of natural vitamin E did not reduce prostate cancer incidence. Achieving higher plasma or tissue levels of a-tocopherol within the physiological range, such as through a 50-mg/d supplement, may have some prostate cancer (or other) preventive effect such as cell proliferation or tumor growth inhibition.
Furthermore, high pharmacological doses of a-tocopherol may have an adverse effect on cytochrome p450 enzyme and other regulatory mechanisms that a lower dose would not have. It is also possible (but not certain) that the known effect of a-tocopherol in suppressing potentially beneficial plasma y-tocopherol [gamma tocopherol] levels would have been less with the lower than higher dose of a-tocopherol.
Second, several studies have suggested that vitamin E is more protective against prostate cancer in smokers, and less than 60% of SELECT men were current or former smokers (whereas all men in the ATBC study were smokers). For example, observational analyses in a trial-based cohort of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO), a trial of screening vs standard health care routines, showed a 71% reduction in the incidence of advanced prostate cancer associated with supplemental vitamin E use in current and recent smokers. . .
The 35,533 randomized men of SELECT were needed because of the robust statistical design accommodating 4 study groups with 5 primary comparisons; this large trial population made SELECT the largest cancer chemoprevention trial ever conducted to our knowledge. African American men have among the highest prostate cancer risks in the world, and SELECT had the highest participation of African American men (13%) of any large-scale cancer chemoprevention trial to date [there may be a significant effect from this factor].
Potential limitations of SELECT include that it did not test different formulations or doses of selenium and vitamin E and that it did not definitively assess results in subgroups of men who may have responded differently than did the overall population. Because of active annual screening (eg, PSA in 85%; Table 3) and early detection (eg, 99.4% stage T1 or T2; Table 3), SELECT could not assess effects in reducing advanced or fatal prostate cancer, which recent data suggest may be a potential benefit of vitamin E and selenium. SELECT also could not assess intervention effects in a population deficient in vitamin E, selenium, or both since our trial population was well-nourished at baseline, or in current smokers since they represented only 7.5% of the SELECT population, a substantial difference from the ATBC study in predominantly heavy smokers.
As a reminder, here is what the initial trial showed in their conclusions (linked below):
There were statistically nonsignificant increased risks of prostate cancer in the vitamin E group (P = .06) and type 2 diabetes mellitus in the selenium group (relative risk, 1.07; 99% CI, 0.94-1.22; P = .16) but not in the selenium + vitamin E group.
Selenium or vitamin E, alone or in combination at the doses and formulations used, did not prevent prostate cancer in this population of relatively healthy men.
So just like the smoker’s study, we see Dr. Seres demonize vitamin E in a non-scientific way, skipping all of these important study details and limitations (including dosages and other specific study circumstances), preferring to embrace the more dramatic headlines and media claims when he confidently states:
In other studies, vitamin E and selenium significantly increased the incidence of prostate cancer.
Really? Do you think the authors would agree with Dr. Seres’ absolute, exaggerated statement? Their concerns and limitations show otherwise, including the pesky issue that the subjects stopped taking their supplements back in 2008, something I bet Dr. Seres doesn’t even know (and remember that there are 8 forms of vitamin E, which any nutritional expert should know and understand, but Dr. Seres continues to refer to it as a single vitamin, again showing nutritional amateurishness)!
Now I think Dr. Seres’ conclusion may be referring to a 2011 version of SELECT, which was done 3 years after the subjects STOPPED taking their selenium and vitamin E. Their vitamin E levels would drop within a few days (the half-life is less than 2 days), and the higher doses for vitamin E in the trial would probably be cleared in a week, no longer having any significant effect after about 7 days. And the 2011 conclusion only mentioned vitamin E, not selenium. So again, Dr. Seres appears to misstate and exaggerate that study finding.
Just for fun, here is a quote for that 2011 update from the NCI on SELECT:
Men taking selenium alone, or vitamin E and selenium, were also more likely to develop prostate cancer than men taking placebo, but those increases were smaller and are not statistically significant and may be due to chance.
Again, a “nutrition expert” seems not to know these important details about actual study findings, yet making bold claims about them? Where is the common sense in these ridiculous claims of increased cancer when there is little possible effect after a week or two, when a re-analysis was done 3 years later! That’s just so unscientific it’s hard to describe! It continues to show such bias, gullibility and ignorance on the part of everyone. These researchers don’t understand nutrition (and their press release quotes have shown strong bias)! Again, we have a “nutrition expert” who seems wholly ignorant of the realities of. . .vitamins, nutrition and cancer.
I want you to stop and think about what you are seeing: A health coach has a better understanding of the important details, nuances, flaws and limitations in research studies, compared to a doctor who claims to be a nutrition expert. And this point is also critical: What the smoker’s study and SELECT prove is that badly designed studies bring bad, non-credible results!
In truth, the flaws in both studies render them largely useless. At most, the studies show that the results are only relevant for similar subjects, dosages, vitamin forms and details of the study, and not broadly applicable. In short, neither study supports Dr. Seres’ bold claims!
But there’s much more debunking to come, including the real risks and causes of prostate cancer! Here are multiple links from doctors and other credible sources that expose the bias, poor science and exaggeration in the SELECT trial, (the rehash version for prostate cancer and “fish oil” was even worse, done by the same anti-supplement people). Dr. Seres seems to again, skip all these other insightful and valid points of view showing that he only looks at mass-media and medical sources that support his pervasive BIAS):
http://drgeo.com/vitamin-e-and-prostate-cancer-study-unnecesary-hype
http://www.naturalnews.com/033911_vitamin_E_prostate_cancer.html
http://www.northstarnutritionals.com/articles/vitamin-e-and-prostate-cancer/
http://www.wellnessresources.com/health/articles/flawed_select_study_attacks_vitamin_e/
http://www.naturalnews.com/024650_selenium_cancer_vitamin_E.html
http://healthtipsfromtheprofessor.com/selenium-vitamin-e-increase-prostate-cancer-risk/
<a href="http://www.lef.org/featured-articles/2008/12/Response-to-Selenium-Vitamin-E-Cancer-Prevention-Trial-study/pag