Here’s a compelling op-ed from a chemistry PhD about the problem with randomized clinical trials. RCTs are the gold standard for testing effectiveness and safety. The problem, however, is that a randomized clinical trial puts the substance in question in a bubble. Remove the substance from its context, this writer argues, and you aren’t going to get an accurate picture.
Hang on, all ye fans of the FDA. I’ll explain. Randomized clinical trials are essential for food and drugs. But the piece points out that the value is not so cut and dried when it comes to vitamin supplements.
Supplements, of course, have been all over the news lately. Recently a spate of stories came out condemning antioxidants. Another called vitamins into question. I’m used to drug companies funding studies and releasing statements about the dangers of vitamins, and Sara and Aaron addressed the whole issue in a scathing little parody at Healthbolt (for adult eyes and a sense of humor only). The FDA will begin requiring supplement manufacturers to test their products and prove that they contain what they say they contain. This is a good thing as far as I’m concerned, though it’ll be 2010 before everything takes full effect, and the policing will be an honor system not unlike the current setup Big Pharma enjoys. So it remains to be seen just how much good this will do in stopping bogus supplements…
At this point in the antioxidant debacle, though, I can tell you that I’m really tired of certain interests truckin’ out the same old scare, and I said as much in a flare at Technorati. Typically, a substance, such as a single antioxidant, is given to a group. Placebos are given, all is randomized, time passes. Sounds great, but it’s not. Thus far, the results from many RCTs have been dismally unconvincing, leading experts to assert that antioxidants are worthless despite loads of observational studies. I won’t regurgitate the whole op-ed here, but consider a worthy criticism of RCTs:
Frequently the supplement is given to an unhealthy population – even terminally diseased groups. Should we really expect miracles here? I’m interested in the etiology of disease and chronic health conditions. I think it’s obvious enough that a combination of risk factors, diet, genetics and environmental conditions are at play in most health issues. Can we reasonably expect a year of, say, vitamin E supplementation to offset 20 or 40 years of cumulative damage from a host of factors?
My advice? Take a broad spectrum of different antioxidants for prevention and overall health, not in a misguided attempt to cure a disease. Nutritional supplements are fundamentally different from drugs in their approach. The former supports prevention; the latter targets specific symptoms and eliminates or mitigates them. In the best cases, and only occasionally, drugs cure disease. In the worst cases, they merely mask pain or alleviate symptoms that indicate an unhealthy lifestyle.
To me, RCTs may be missing the big picture with antioxidants: synergy, baby.
A new study out today confirms the antibacterial power of both red and white wine. Apparently, researchers have proven that wine destroys the bacteria responsible for cavities and throat infections. Interestingly, it’s not the alcohol that kills the germs, but rather acids in the wine.
Imagine the possibilities here:
- Stop fighting the nightly battle with your toddler and the toothbrush. Just get ‘em tossed instead. Sure, they’ll be a little hungover at preschool, but you can never be too careful when it comes to your child’s dental health.
- Until cough syrup comes in a believable-tasting grape, wine has won points for flavor. Now we see that “Grandpa’s medicine” really is medicine. Because if you’re calling in sick, you might as well be drunk.
No wonder bums have such great teeth! I’m being facetious, of course. I don’t know if replacing your toothbrush with a wine glass is such a bright idea.
The study was a test-tube run, and when the active acids were removed and tested on their own, they killed germs better than the wine. So while wine is a naturally antibacterial beverage, other properties in the wine probably cancel out any benefits. The study also illustrates the fact that just about anything can be promoted as having a health benefit.
For example, because wine contains the antioxidant resveratrol, it’s touted as being healthy. While there’s plenty of evidence to suggest modest amounts of alcohol may exert some protective cardiovascular benefit, to reap serious antioxidant benefit, you’d have to drink enough jugs to put Gallo out of business. I think wine, in moderation, has healthful properties. But don’t expect wine to save your arteries if you’re not also living a healthy lifestyle. You’re better off eating fresh fruits and vegetables and supplementing with a multivitamin that contains antioxidants.
The moral here is that even scientists can justify that Dionysian dinner tab as a business expense.
Ah, the joys of merch.
Sara your editor here. For the die-hard Fuji fans and apples everywhere who simply must accessorize with all things MDA, we present:
The adorable Fuming Fuji mug! Fume along with El Fritter every morning as you catch the latest health and fitness news. Click the mug to check out all the great Fuming Fuji and Mark’s Daily Apple accessories.
If you’re a customer of Mark’s awesome nutrition supplement company, Primal Nutrition, you can also get fun items with that super-cool “is it a sanskrit symbol? is it an infinity symbol? what exactly is it a symbol of?” symbol. We don’t know either, but it sure looks good on a shirt or an eco-friendly bag. Admit it. You want one.
While I’m swimming around in this post, I’d like to catch you up on some of the changes you may have noticed ’round ye ole blog. We’ve been experimenting with some different posting schedules and formats. For example, we’ve stopped the daily news updates (Worker Bees’ Daily Bites) and begun bringing you a comprehensive list every Friday of all the most interesting, important, and informative health news (Worker Bees’ Weekly Buzz). Do you like this format? Do you like the changes you’ve seen? Please let us know what you want to read more of as Mark’s Daily Apple continues to grow and evolve.
What it is:
Neither a pine nor an apple, the pineapple is actually a fusion of many “fruitlets”. The pineapple is special for many reasons, but for the science nerds, this is one of the only bromeliad fruits humans eat. A bromeliad can be either an epiphyte (rootless, chillin’ in the air) or a regular old terrestrial, such as the pineapple. (At long last, tropical biology in the Costa Rican mud pays off…gems, I tell you.)
Why it’s smart to nosh:
Pineapple is the only food which contains natural bromelain, a group of enzymes that aid in digestion, reduce inflammation, reduce swelling, and speed healing. Bromelain is great for those with muscle and joint injuries, arthritis, gout and other inflammation issues. You do have to eat the pineapple fresh, however – cooking deactivates the bromelain (so much for feeling hopeful about the Carl’s Jr. Hawaiian burger ads).
Pineapple is a rich source of manganese, an important mineral. Among many important roles as a cofactor, manganese helps superoxide dismutase do its free-radical-bustin’ job.
Pineapple is loaded with antioxidant vitamin C, too!
The Fuming Fuji is outraged at the marketing of toxic food, especially when it is aimed at the small fry. This week, El Fritter has decided to have a serious problem with Kellogg’s.
But, Fuming Fuji, you’ve been very vocal of late about your feud with David MacKay, Kellogg’s CEO. This seems like a thinly veiled attempt to lash out at your rival. What could you possibly have to gripe about when it comes to Kellogg’s? They just announced they’re making many of their foods healthier – and they will no longer be marketing sugary products to children under 12!
The Fuming Fuji says no!
The claim: Fuji, clearly this is personal. I don’t even want to hear it. In fact, I’m starting to think you just have a problem with breakfast. In the last six months, you’ve fumed against breakfast bars, breakfast cereals, breakfast waffles. Maybe you just need therapy, Fuji.
The catch: Clearly you are projecting. The Fuji cannot help you with that, he is not trained in psychotherapy. While MacKay and the Fuji have been feuding with a furor only outdone by Rosie and Donald, this has nothing to do with my anger over his hypocrisy. I am furious about the junk that Kellogg’s slings at the small fry! Big Agra’s tartlets of pop and not-berry death nuggets should not fool anybody, even you, my carbaceous foe.
The comeback: Rosie and Donald Trump, huh. I wouldn’t go that far. You’re an apple. Maybe Paris and Nicole, though.
Here’s my “carbaceous” opinion: So Kellogg’s will still be selling products they decide they cannot reformulate into healthier versions – yeah, maybe that’s a tad disingenuous. Okay, maybe a lot, actually. Wait, where was I going with this?
Oh, yeah! At least they’re not going to market unchanged products to kids, and they won’t be using cartoons to hawk the junkier stuff. Isn’t a little progress better than none? Snap! I think you’re just being stubborn, Fuji. Some would say obtuse.
The conclusion: Good for you and your knowledge of angles. Unfortunately for you I have the right angle. Ha, ha. That is a little geometry joke. I do not know this “snap” you speak of, but his cousin Crackle is a real little weasel, let me tell you.
Mark the Fuji’s words: Kellogg’s will not change very much. What little they change they will brag about like they invented Christmas.
The catchphrase: Kellogg’s: new and improved, because we didn’t feel like a lawsuit!
Disclaimer: Mark Sisson and the Worker Bees do not necessarily endorse the views of the Fuming Fuji.
Hat Tip: Get the full scoop (food police lawsuit, ensuing settlement, ensuing “we felt like changing, no reason, really” announcement from Kellogg’s, and the ensuing blogosphere buzz) at the informative youth advocacy blog Shaping Youth. Thanks, Amy!
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