Anti the anti-supplementers - Summer 2009

There is nothing more powerful,’ said the French poet Victor Hugo, ‘than an idea whose time has come.’ Some commentators have taken this to mean that the truth must, eventually, out – but this is a Panglossian reading. The idea doesn’t have to be a good one. What life actually teaches us is that there is nothing more powerful than a delusion whose time has come, whether this is Stalinism, Fascism or – to turn back to my own lathe - pharmaceutical medicine.


Pharmaceutical medicine is, of course, the dominant medical model today. One of the largest sectors of the entire global economy (along with arms and illegal drugs), Big Pharma has infiltrated the regulatory and political systems, the medical curricula and the clinical research establishments. Most invidiously, it has colonised the way that medics and medical scientists think. The poor things are taught at medical school that the key to health is pharmacology (it is), but that the only pharmacology that matters is pharmaceutical pharmacology – which is, of course, the big lie. So big, in fact, that most doctors today are completely incapable of thinking beyond it.


They merrily keep on prescribing statins, anti-hypertensives and anti-diabetic drugs as per their instructions (which were drawn up by committees heavily influenced by the drug companies), blithely ignoring, for the most part, the rising tide of degenerative disease that floods their surgeries twice daily. All the perfumes of Arabay, and all the drugs in their pharmacies, have no effect on the pandemics of diabetes, cancer, dementia, osteoporosis, gout, auto-immune disease, arthritis and allergy that are wrecking so many lives, and costing us so dear.


They search blindly, obstinately for answers in the pharmacopeia, while ignoring the mountain of evidence that shows with absolute clarity that the way to a healthier population and reduced health care costs is through the food chain. Countless studies of the contemporary Mediterranean diet show an improved diet leads to improved health, with up to 15% reductions in the incidence of heart disease, cancer and dementia (ie de Lorgeril & Salen ’08, Scarmeas et al ’06, Scarmeas et al ‘08). And we can do better than this. The ‘super-Mediterranean’ diet consumed in mid-Victorian Britain reduced heart disease and cancer by a staggering 90% (Clayton & Rowbotham ’09).


It is obvious that better nutrition dramatically improves health (as any farmer already knows), and as a pharmacologist I can assure you that it doesn’t matter if the critical nutrients are given in food, functional (fortified foods) or supplements. So why, when some medics so keen on giving (out-dated) advice about diet, is the establishment so consistently hostile about supplements? And why are there so many scientific publications about the uselessness and dangers of supplements?


I’ll start with an editorial published in the esteemed Journal of the Federation of American Societies for Experimental Biology (FASEB) last month (Weissman ’09). Weissman complained, “Dietary supplement are nostrums … you see so many claims for supplements that promote ‘joint health’, ‘breast health’, or ‘male vigor’ rather than more precise claims that would have to be validated by the FDA in regard to ethical pharmaceuticals.”


He’s right. Most supplements are designed around the latest fashionable nutrient, or to a price point, and from the formulations it’s sadly apparent that they have little to do with science. The unfortunate truth is that too many supplement companies sell little more than contemporary versions of Tono-Bungay, the toxic cure-all in H G Wells’ Edwardian satire. That, of course, is not an argument against well-designed supplements.


It is also true that the results of the latest intervention studies of ‘antioxidants’ make up a long list of failures (ie Sesso et al ’08, Gaziano et al ’09, Lippman et al ‘09). But when you look at the bizarre and ignorant combinations of (often synthetic) nutrients that are used, it is not hard to see why the results are often negative. The question then arises, why were these trials so badly designed? There are two possible explanations.


The kindest one is that clinical scientists are still so obsessed with the Pharma model (one drug in, one variable measured), that they genuinely don’t understand the futility of mono- or oligo-therapy. They fail to understand that most of their trial subjects are, like the scientists themselves, depleted in most micro- and phytonutrients; and that the only rational way to enhancing their health prospects is to provide wide-spectrum nutritional support.


The other, more malignant idea is that Big Pharma really does get it. They know that better nutrition would create vastly improved public health, and vastly reduced revenues for themselves. And they are fighting a very clever, legalistic and methodological long game to prevent that disaster from ever coming to pass.


A nutritional programme (‘Nutriplete’) has just been approved for Medicaid reimbursement in several US states, where it is available on prescription. It contains 29 active ingredients, and is a rational and well-designed formulation. The reimbursement issue was fought tooth and nail by the drug companies, but this product eventually won through. This is a vital development, as the anti-retroviral drugs used to treat HIV / AIDS are toxic, and fast losing their effectiveness as viral resistance continues to increase.


Clayton P, Rowbotham J. How the mid-Victorians worked, ate and died. Int J Environ Res Public Health. 2009 Mar;6(3):1235-53


de Lorgeril M, Salen P. The Mediterranean diet: rationale and evidence for its benefit. Curr Atheroscler Rep. 2008 Dec;10(6):518-22. Review.


Gaziano JM, Glynn RJ, Christen WG, Kurth T, Belanger C, MacFadyen J, Bubes V, Manson JE, Sesso HD, Buring JE. Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians' Health Study II randomized controlled trial. JAMA. 2009 Jan 7;301(1):52-62.


Lippman SM, Klein EA, Goodman PJ, Lucia MS, Thompson IM, Ford LG, Parnes HL, Minasian LM and 25 other authors. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2009 Jan 7;301(1):39-51.


Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA. Mediterranean diet and risk for Alzheimer's disease. Ann Neurol. 2006 Jun;59(6):912-21.


Scarmeas N, Luchsinger JA, Mayeux R, Schupf N, Stern Y. Mediterranean diet and mortality in a US population. Arch Intern Med. 2008 Sep 8;168(16):1823-4


Sesso HD, Buring JE, Christen WG, Kurth T, Belanger C, MacFadyen J, Bubes V, Manson JE, Glynn RJ, Gaziano JM. Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. JAMA. 2008 Nov 12;300(18):2123-33.


Weissmann G, The Atlanta Falcon and Tono-Bungay: Dietary Supplements as Subprime Drugs. The FASEB Journal. 2009;23:1279-1282