The truth that I have seen is that many Americans suffer from some type of ailment that traditional medicine offers no elucidation of the cause. It could be diet, lack of exercise, mental health but there is not explicit test to say, "yes, you have ailment X because of Y."
So what is one to do? IMHO, the best one can do is to persevere and try to survive the best they can. One way of doing that (and I think a very productive way) is to be a scientist of your body and try different things. For some exercise works, for some vitamins, for others a certain type of diet.
I will not judge another for trying to take care of themselves as best they can. However, I will judge against how scientific they are about doing so to a degree only to critique their methods in hopes they can reach a state of reasonable comfort if they havent already obtained it.
Spend an afternoon reading examine.com. Follow the studies. Read conflicting studies. Read about placebo. You will see that these supplements do help a significant portion of the populate for condition X. Not everyone though and likely because conditions X is really a superset of conditions X0, X1, ... XN. Until we can elucidate condition X into its true subcomponents, I think Americans will continue to seek their supplements.
The whole problem with being your own scientist and blind testing things is the potentially long transitions to deficiency. And then there is the matter of spotting problems. Feel like filling in a questionnaire 4 times a day? (A full dietary and extra of "feel" plus any ailments. Do extended bloodwork every some time.)
Then knowing how to apply statistics properly?
This is not viable for most people even with modern tools...
On the other hand it is a decent way to lose weight by pervasive tracking according to a few studies.
> Feel like filling in a questionnaire 4 times a day?
I'm currently working on a paper showing you can track 2 things every day (total of 3 measurements) and make quite an improvement for a common health condition.
> Then knowing how to apply statistics properly?
Yes and no. The ultimate gauge is how the person feels. If its placebo then so what. If they can afford it, who am I to say its wrong.
Also, many intelligent people are involved in the supplement movement and beginning to organize well and document. Applying an ANOVA isn't that difficult to do. Any large university will also have a statistical consulting center which you can visit to have them review your "tests" and explain a good way to do the stats (I've done this).
> On the other hand it is a decent way to lose weight by pervasive tracking according to a few studies.
I think you're understating people's ability to listen to their own body, and using an ungenerous definition of 'feeling'.
Listening to your body is a skill that can be developed over time. Several years ago, I did not pay attention to, or was not aware of, any relation between what I ate, and how my body felt afterwards, what things looked like on the other end, etcetera. After starting to work out and taking my health seriously, I spent more time tracking things like 'how does food X agree with my stomach? How does it affect my energy levels when I have sugar in the morning?', and learned a lot. There are foods now I'm very hesitant to touch, that I would have eaten without a second thought several years ago, because I now know they affect me personally in undesirable ways.
This is not to say that one should eschew the scientific literature, or their doctor's advice. You should just take both into account.
I think the context is in how the person feels physically and psychologically in the long-term. Psychics seem to market to those who have a short-term life issue like needing closure from a dead loved one or needing to know if their luck is going to change.
You can still tell them the truth. You can say "we don't know if the supplement is doing anything useful chemically, but the act of taking it seems to help you." I wouldn't have any trouble morally justifying that.
> By that metric, psychics saying they can talk to your loved ones can be morally justifiable.
A truly altruistic lie, while less moral to tell than the truth, can in many cases be more compassionate and do less harm over the long run.
Issue is, there are very few truly altruistic lies (most of them are told in obituaries, goes the pithy one-liner). Most seemingly-non-damaging lies are told for dual benefit if the liar and the recipient. In your example, the psychic is out to make a buck. This is personal and debatable, but I consider such "it makes you feel good but I'm only telling you 'cause it enriches me" statements to be less moral than truly altruistic lies (which are less moral than the truth), but more moral than malicious/victimizing lies (e.g. "no, Charlie Brown, I won't move the football this time").
You exactly nailed the problem on the head. Modern medicine is totally off track we have specialists that zoom into to a particular part of the body missing forest for the trees.
I see tons of supplements in costco for joints , apparently only solution that modern medicine has come up for "arthritis" is taking crap loads of NSAIDS which often make the problem worse and cause new ones like gastro troubles, now you are taking NSAIDS and reflux meds which in turn cause more troubles. Everyone goes on pretending that this is some sort of cutting edge "modern medicine" . Disgusting.
I think this is how we should revamp science education. Teach people how to examine the evidence and how one can fool themselves. Less inclined plane problems, more scientific reasoning.
Great points. The very existence of the placebo effect proves that "inert" substances do, in fact, work for some people, even if the effect is purely psychological.
Some vitamins do work for some people. And science is about finding what works.
Not "purely" psychological though - that would be a delusion, which we presumably don't consider 'working'. Perhaps it would better to say that while the effect is somatic, the cause is psychological?
I see this as another symptom of USA consumerism. Your feel a little stressed? Take this tranquilizer! You feel tired? Take these vitamins!
As a consumer the idea that you can let your problems go away by just swalling a couple of pills is tempting. And the doctor and the farmaceutical company are making some money on it as well.
The reality is that staying healthy and vital at an older age takes discipline and effort: you need to eat and drink moderately, keep a balanced diet, exercise regularly and get enough sleep.
But that's a tough message to sell and nobody is making money on it.
"I see this as another symptom of USA consumerism. Your feel a little stressed? Take this tranquilizer! You feel tired? Take these vitamins!"
On the selling and purchasing end, that may be the case. No sarcasm, I mean that.
But they still need something to get a hold of to work. I think if we dig down one layer farther, what they represent is Western science's tendency towards excessive reductionism. Reductionism has its place; it has been very powerful and we've done a lot with it. (A software engineer who thinks reductionism is all bad has not thought very carefully about their their job...) However, the 20th century in my opinion had a really bad run with reductionistic views of the human body. Hence, for instance, the continual flipflopping between eggs being bad or good for you, in an attempt to reduce "egg" to an atomic element and class "good" or "bad" on a single-dimensional scale, when in fact "eggs" are insanely complicated and goodness and badness are horrifyingly n-dimensional things hard to even characterize. Vitamins are clearly important, but science has tried too hard to reduce characteristics of the body to the impact of this one single chemical on this one single problem, or things like that.
I wouldn't even say the science was bad per se; if you only have access to enough computational power to build an 8-dimensional model of a thousand-dimensional process, the best you can do is get a very reduced-power model. It may still be better than nothing. But I do think there was a lack of deep understanding and proper humility in the 20th century, and ongoing into this one. Far too many scientists and science journalists drawing lines through single points, or n-dimensional hyperplanes through underconstrained data sets, filling in the direction of the lines with their own unscientific biases.
And that's before we discuss the reductionism of attempting to model everything as linear processes, because that the "bright spot of light under the lamppost" that we can be metaphorically looking for our keys because the math works nicely for those cases, despite the obvious and abundant evidence that our bodies can not be modeled via linear processes....
(And let me both start and end on the fact that I'm still not necessarily disagreeing with you about the consumerist aspect, just trying to dig one layer further down.)
"Balanced diet" is just a way of hiding the difficulty. How many dozens of ways does a diet have to balance, and how much leeway do you have on each one? Nobody really knows. A supposedly-balanced diet could still be lacking in vitamin D or iodine or...
If you can solve some of those factors with a pill, why not? Supplementation is not a cure-all but it can help in a lot of cases.
Note that I'm talking about small doses here, not taking tons and tons of arbitrary substances.
> For most of the people with "dieting" problems, stop eating any junk food is a good enough "balanced" diet.
That - naively - assumes that people know what / how to eat and cook when you take away junk food. I also gathered there's huge areas and neighbourhoods without access to a normal grocery store - you know, places where they sell vegetables and such.
I have been telling my spouse "stop buying junk food" for literally 15 years, without interruption. Every time, the response: "yes, I know" when agreeable, and "what constitutes 'junk food'?" when contrarian. It still somehow shows up in the house all the damned time. I'm not going to place the blame entirely on someone other than myself, because I do eat the crap instead of throwing it in the trash, but can I really threaten separation over one box of brownie mix? Is it any more reasonable to split over a thousand boxes of brownie mix?
We both know how to cook--perhaps a bit too well. Even if we didn't buy boxed brownie mix, we could still make brownies from staple ingredients and a bar of baker's chocolate. Or cookies. Or pies. The difference between us is that I refrain from doing so. You really have to take away the bag of refined sucrose, and the bag of white flour, too. And then you have to take away the corn, rice, and potatoes, because some impoverished ancestor figured out how to make "sweets" (read: black-market booze) out of the cheapest starch available, and if you stop short of the fermentation, it's still not-entirely-disgusting to eat as is. "Stop making junk food" is taken a bit too personally.
As I am not a peasant farmer that works heavy manual labor for 12 hours a day, there is no amount of exercise I could squeeze into my schedule that could compensate. I could stop myself from eating it, of course. I could quit at any time I wanted--probably without even checking in to rehab.
What you need is to know how to cook just enough to heat meats to the correct internal temperature, steam vegetables so they are neither crunchy nor mushy, and make vegetable soup, and then also not have the ability to make things more delicious with added fat, salt, and sugar.
Food deserts may be a thing, but that is also because the more nutritionally-dense-per-kcal fresh produce is expensive in relation to the boxed and canned junk foods. And some vegetables cost more than others. A 10# bag of potatoes can cost less than two heads of cauliflower. A 20# bag of white rice can be less than 2# of brussels sprouts. Carbohydrates are simply cheaper than vitamins-in-foods. If you can't afford a car to get to a grocery store on demand, you can't afford to replace all your junk food with fresh produce, either.
For me personally diets that switch between what I eat never work. My wife is an amazing cook, she cooks for fun more than as a sustenance which means there is always amazing stuff to eat around the house.
The only things I HAVE been able to do (I went from 223 to 152 now) are:
- track what I eat exactly without cheating.
- account for equivalent amount of base calories + exercise.
- control the # I eat of all the fancy stuff. If it is a brownie, I have to walk away after half a piece. If it is a couple of cookies, no lunch.
In general, there hasn't been an easy replacement meal. Thankfully I control breakfast and lunch (oats / skip it / replace with carrots/eggs etc. in office) and I ride over weekends.
And your comment - cynically - assumes that no one knows how to cook anything. A friend of mine who works in a VA hospital sends every patient home with a cheat sheet on how to cook vegetables to make them delicious and has seen fantastic uptake, especially when the card comes with an explanation of how much better your life can be if you'd stop eating refined sugars and pre-packaged foods.
There are entire industries based around selling dieting advice and health anxiety. I don’t buy that americans actually view multivitamins like this or I would stop seeing gluten free shit in whole foods.
Ideally I would periodically track my diet for a few weeks and only supplement for deficiencies, but I've found that when I track what I'm eating, I eat differently.
So instead I take half a multivitamin to ensure I'm not totally deficient in anything. Reasoning:
> On this point, let me emphasize the logical corollary which I've spelled out repeatedly but that people keep missing: unless your diet is composed entirely of fries, Coke, and fast-food burgers with the lettuce, ketchup, and tomato thrown out, no one should be taking a full daily dose of any commercial multivitamin. You are absolutely guaranteed to get too much of many nutrients, and to create or exacerbate imbalances in others.
What does it cost to go to a doctor and get tested for deficiency? You'd only need to do that once a decade or after implementing major changes to your diet. I have a feeling it would come out to less than your strategy of eating pills "just in case".
It's not quite that simple.. Firstly, it is surprisingly costly and it's getting more so because of several factors (a big one being insurance company regulation around requiring tests to be linked to diagnosis codes. This makes the doctor look bad for giving "unnecessary tests" which in turn makes them not want to give you a test if there isn't clinical evidence to warrant it, regardless of your desire and willingness to pay for it).
Secondly, you need to be tested much more often than once a decade. Levels can vary wildly based on diet in sometimes complicated ways. For example? Vitamin D levels are dropping despite no changes in vitamin D intake (and sun exposure). This turns out to be a calcium deficiency, which is required for vitamin D absorption. The calcium deficiency in turn results from some other condition not necessarily related to diet.
You also need to be re-tested potentially many times after beginning a supplement to determine if you are at the correct dose. In some cases when the supplement can be dangerous at high levels (such as Vitamin B6 or Iron) you need to be tested regularly for a while to ensure you aren't overdosing (especially B6 levels too high can cause nasty symptoms).
Source: personal experience doing exactly this with a variety of vitamins and minerals
You should find a doctor who doesn't take insurance. Out of pocket will be higher, but you can file for reimbursement yourself to offset some of the charges, and the doctor shouldn't have a problem offering a test.
Tests for most of those micronutrients are not very precise, and actual blood levels can fluctuate widely from day to day or even hour by hour depending on what you just ate or how active you've been. So in order to establish a reliable baseline you'd have to do multiple lab tests spread out at various times over several days.
The most common deficiencies are vitamin D, iron, magnesium, vitamin B12, and vitamin B9. Maybe $200-$300 to get them checked without insurance. I think most people shouldn't be concerned about supplements except vitamin D and iron. Just eat a varied diet.
You could instead figure out how to incorporate dark leafy greens into your diet a few times a week. They are basically multivitamins in plant form.
Have you ever had blanched & sauteed fresh spinach? Blanch for three minutes with a little salt, squeeze out water, saute gently at 4-6 on the dial in a little butter. Really good.
>...You could instead figure out how to incorporate dark leafy greens into your diet a few times a week. They are basically multivitamins in plant form.
It really isn't that simple. One issue is that it doesn't matter how many vitamins are in spinach if you don't absorb them.
>...Circulating phylloquinone levels after spinach with and without butter were substantially lower (7.5- and 24.3-fold respectively) than those after taking the pharmaceutical concentrate. Moreover, the absorption of phylloquinone from the vegetables was 1.5 times slower than from Konakion.
And while spinach will get you some K1, it won't get you K2 which is important for how calcium is handled in the body.
>...We examined whether dietary intake of phylloquinone (vitamin K-1) and menaquinone (vitamin K-2) were related to aortic calcification and coronary heart disease (CHD) in the population-based Rotterdam Study.
>...The relative risk (RR) of CHD mortality was reduced in the mid and upper tertiles of dietary menaquinone compared to the lower tertile [RR = 0.73 (95% CI: 0.45, 1.17) and 0.43 (0.24, 0.77), respectively]. Intake of menaquinone was also inversely related to all-cause mortality [RR = 0.91 (0.75, 1.09) and 0.74 (0.59, 0.92), respectively] and severe aortic calcification [odds ratio of 0.71 (0.50, 1.00) and 0.48 (0.32, 0.71), respectively]. Phylloquinone intake was not related to any of the outcomes. These findings suggest that an adequate intake of menaquinone could be important for CHD prevention.
While I've seen estimates that the "adequate" amount of K2 is estimated to be 120 mcg per day, it was only with 200 mcg that the proteins that are dependent on Vitamin K2 were almost fully activated:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321262/
To get 200 mcg of K2 from cheese, you would likely have to eat about 1 pound of cheese a day. If you dislike taking supplements, I'd suggest trying to develop a taste for natto.
While I generally agree, I don't think it's a universal prescription. There are biological defects that inhibit nutrient processing and can require you to take considerably more of said nutrient than you could feasibly acquire from diet.
As one simple example, I burn easily in the sun vs most people I've known. Maintaining healthy blood levels of Vitamin D via the sun, is both risky (cancer) and time consuming for me. It's essentially impossible to fully offset the sun via food-derived VitD. That's especially true if you believe a healthy VitD blood level is closer to 50-70 ng/mL than ~20-40.
Vitamin D3 supplements to the rescue. Prior to supplementing, my blood levels were at 5 ng/mL, very dangerously low (despite eating a diet that regularly includes fish and eggs).
The exception makes the rule; D is the one vitamin I'm aware of whose primary source was never food. Thus, it would not be shocking if food sources were a challenge.
An interesting question though- how many IU do you take? What's your absorption rate, and what's the absorption rate from e.g. salmon? I recall hearing, frequently 10% or less of the D in supplement form is actually absorbed.
But you only need to eat a few Brazil nuts to get enough selenium. More than four a day and you risk selenium toxicity. And they go great with spinach! And the fat increases absorption of fat soluble vitamins in the spinach.
I think once they reach a certain age, people stop looking at vegetables as not tasty and they are simply not consumed as often due to either (a) the price or (b) the convenience.
So far as I can tell, the only reasonably common deficiencies are vitamin D and magnesium, and among women anemia.
Every other deficiency is in the tenths of a percent range, well outside of the level at which people in the general population would be treated if it were e.g. antibiotics or other non dietary drugs.
Iodine deficiency is still shockingly widespread. According to World Health Organization, "Iodine deficiency is the world’s most prevalent, yet easily preventable, cause of brain damage."
http://www.who.int/nutrition/topics/idd/en/
Most people who have B12 deficiency like my mother, are unable to absorb the oral form due to some type of malignancy. Injections are the only way to increase serum levels for her.
There are varying forms of oral B12 supplementation.
The sublingual kind does not involve the digestive system, it's absorbed diffusely at the mouth/throat. Jarrows makes them in methylcobalamin form.
Note however in my experience it caused painful neck stiffness after a week of use. But there were other positive effects observed, so it was definitely doing something. The lucid dreaming on the first couple days was quite interesting.
In a study of college athletes, males were deficient in about 40% of the vitamins and 50% of the minerals required. The female athletes were better but were still deficient in 29% of the vitamins and 40% of the minerals RDA.
Zinc is a really significant one for vegetarians, and no-one talks about it, because pretty much the only usual dietary sources for zinc are meat-based.
> Other good sources of zinc are nuts, whole grains, legumes, and yeast. [1]
I've found nuts are basically a super food. No need for refrigeration or preservatives/processing to keep edible. I always have bags of shelled organic nuts on hand and eat handfuls on a daily basis. The only down side I've found is cost; nuts, especially organic ones, are more costly than filet mignon per lb at whole foods.
Note that the first non-meat source (other than fortified breakfast cereal) is baked beans and you'd have to eat at least a full can a day to get your RDI. Or I guess you could eat 2.2kg of yoghurt.
I'm currently holding a 340g bag of raw organic walnuts I opened this morning, and it's nearly empty just from snacking throughout the day. Also snacked on sunflower seeds, but not much.
Dinner was a large bowl of lentils, which have 3.5mg/100g (35%) [3]
Without even optimizing for it I'm over the RDI for Zinc without animal products, this is just what I happen to be stocked up on currently. So clearly it's not much of a challenge for a vegetarian to get sufficient Zinc.
Eating meat is perfectly natural, humans are opportunistic omnivores. It's weird that I don't, and I wish it were an option for me, but I've just always been too creeped out by the thought of eating parts of another animal's body.
Boron? What on earth would you do with that? Is it used in some metabolic process somewhere?
edit: Ok, according to "Devirian, T.A. and Volpe, S.L., 2003. The physiological effects of dietary boron."
> Boron is known
to influence a variety of metabolic actions. It interacts
with calcium, vitamin D, and magnesium,
which are all important in bone metabolism. Boron
accumulates in bone in concentrations dependent
on the amount of boron consumed. Boron has also
been found to increase steroid hormone concentrations
in postmenopausal women and to have antioxidant
properties, which could make it beneficial
in preventing atherosclerosis
Read the page again about 10% estimated below RDA in the US. Then the RDA is not exactly very well validated and being below it does not mean being deficient.
You can tell if you have zinc deficiency if you have those white dots on your fingernails. Although that's more in the range of "severe deficiency" so if you ever notice that symptom you should try to be more mindful about your zinc intake in the future (food or supplements).
Vitamin D supplementation for vitamin D deficiency that is quite common is not controversial at all.
If you mean taking more D than is needed, your are correct.
You can measure the D vitamin levels from blood serum.
< 30 nmol/L is vitamin D deficiency
30 - 50 nmol/L is considered inadequate
50 - 125 nmol/L is adequate
> 150 nmol/L evidence of potential adverse effects
but shouldn't you always complement vitamin d intake with vitamin k? If I recall correctly (I am not sure!) then vitamin d without vitamin k can be harmful.
Vitamin K is found in vegetables, so you don't need to supplement it. I think the worry is that too much Vitamin D contributes to buildup in arteries over the long term, and K helps to clean it.
Can you elaborate? I've never heard anything about that before.
Your body can handle massive amounts of vitamin C and D, so its a bit surprising to hear that supplementing the (generally) small amount you'd find in a vit D pill could be harmful.
While it is basically impossible to overdose on Vitamin C, you can overdose on Vitamin D. It is fat-soluble, thus overdosing has a cumulative and delayed effect.
However, that does not mean that vitamin D supplements are suspect in principle, just that before starting on a course of supplements, it might make sense to have your Vitamin D levels checked and the right dosage determined.
From your page:
> The recommended dietary allowance is 15 µg/d (600 IU per day; 800 IU for those over 70 years). Overdose has been observed at 1,925 µg/d (77,000 IU per day).
So it seems you could even take 10x the recommendation and be fine. The risk of a reasonable supplement pushing you into overdose territory seems negligible.
"The evidence is clear that vitamin D toxicity is
one of the rarest medical conditions and is typically due to intentional or inadvertent intake of
extremely high doses of vitamin D (usually in the
range of >50,000-100,000 IU/d for months to
years)".
The significant advantages of D3 supplementation for sun-starved people are evident in the literature.
As far as I've heard 10,000 IU is regarded as almost definitely non-toxic, and toxicity seems to have been noticed around 40,000 IU per day.
However, in the summer you may want to drop that below 5,000 or even stop supplementing completely, depending how much you're in the sun.
Vitamin K2 also seems to be necessary in combination with D3. But it's not clear to me if 100 mcg MK-7 is enough or if you need to supplement Mk-4 more often or eat more MK-4 foods (the latter is probably preferable).
The largest-dose individual, non-prescription vitamin D supplement pill I have ever seen is 5000 IU, so you'd have to take 10 of those every day, for months, to develop a toxicity symptom. At that point, the per-pill cost of the supplement and the sheer number of pills combine to discourage overdose.
If you have a confirmed deficiency, a doctor can prescribe a limited course of higher-dose pills to get your serum levels back up quickly.
I take cholecalciferol (D3) and menatetrenone (K2-MK4) daily, along with a multivitamin that was essentially a gratis 2.7-year supply, thanks to a fortuitous coupon + sale price interaction, so it isn't actually just making my pee more expensive. I'd feel wasteful throwing it away after someone paid me to take it home, and it'd be great if it activated a placebo effect.
Ironic how the majority of replies in a geek thread are so confident about health when we know - statistically speaking - the majority of you geeks are in terrible health!
Right, pattern recognition is evil except it is used by geeks to build targeted advertising... You sound bitter. Can't help but instigate a little in a thread full of various arguments that aren't mutually exclusive, but whose proponents seem unwilling to duke it out. Yeah, right, I'm talking like a "jock" now slams locker door :P
Northerners with a vitamin D deficiency, 3rd-worlders with iodine deficiency, vegans with B12 deficiency, carnivores with K12 deficiency, women with iron deficiency, etc- yes, supplements are quite helpful, when you're acutely deficient.
But if you're not actually deficient, they can be legitimately harmful, and your average person reading HN is probably not acutely deficient in any of these things you listed except possibly vitamin D.
I'd rather not wait until I'm 'acutely deficient' before acting -- mildly deficient is good enough for me, especially given the concept of triage: metabolism prioritises certain processes over other still important processes according to intake of key nutrients. Hence recommended minimal amounts may be sub-optimal in various cases.
Also, given the increased tendency to ban and censor stuff nowadays, I want to help protect individual choice in this area. If medics have to prescribe them you know they'll be slow and 50X pricier.
At least seek to be smart about it, and perhaps supplement with low values- 10% of DV instead of 10,000%.
Toxic iron dosage can be as low as 2x the therapeutic dose, and men are especially at risk (most of us on this thread are probably men). Long term studies have also repeatedly found negative expected outcomes from supplementing various vitamins/minerals in large quantities (Calcium, C, E, & A come to mind)
The cynic in me believes that for every salesman out there (vitamin or otherwise), there's someone or some article telling you that you are "deficient" in some way.
I'll drink to that. See the link elsewhere in this thread arguing, based on literally 100% assertion and 0% evidence, that we are all probably 10-100x deficient on daily iodine intake.
I know this is anecdotal evidence, but my granddad took multivitamins faithfully for years. After my grandma passed from cancer, and due to not eating as much food with those vitamins, his body had a calcium build up to a state of calcium poisoning. This did a number on his kidneys. His kidneys did not recover. Instead of dialysis , he chose hospice. Multivitamins have the potential to give too much for the body to handle.
Yeah, that's a great point -- especially for older people, you have to tell doctors all supplements you take, because some can affect how fast your blood will clot. For instance, I believe garlic supplements reduce blood clotting, so an older person (especially) might have complications during a surgery.
Maybe hooked is over doing it - probably overly optimistic or misguided is more correct. But this passage is most relevant.
> Often, preliminary studies fuel irrational exuberance about a promising dietary supplement, leading millions of people to buy in to the trend. Many never stop. They continue even though more rigorous studies — which can take many years to complete — almost never find that vitamins prevent disease, and in some cases cause harm.
The way I think of this is: "Food is not a linear combination of nutrients". The system is more complicated than that. It includes your body and the food supply.
Science is inherently reductionist (isolating variables), and in the case of nutrition, this can fail badly. The holistic view is more accurate.
(Although, this is all relative to what has come before; there are of course basic nutritional deficiencies like lack of vitamin C causing scurvy.)
I have to give credit to Michael Pollan for writing clearly about this over many years.
Americans enjoy how a convenient pill can "fix" their micronutrient problems and make them "healthier." In reality, their macronutrients are so imbalanced that these little micronutrients do little to counterbalance overall bad dietary choices. Specifically - the carbohydrate-heavy diet in the USA is unequivocally contributing to skyrocketing rates of obesity, diabetes, and heart disease.
Separately - I'm surprised that this article does not mention Vitamin D. Recent research seems to indicate that it is so important that it is closer to a hormone than a vitamin. [1]
Edit: For anybody interested in this topic, check out the product and blog of the startup Virta Health. They are using diet to cure type 2 diabetes. Raised $45M this week. (I'm not associated with them). https://www.virtahealth.com/
Actually, it's more likely that the issue is we're not eating a mostly whole foods, plant-based diet. It's not carbs that are the problem, but refined carbs certainly are a problem. They're not what our bodies evolved to thrive on. I highly recommend watching Dr. Greger's talk at Google[0] on the subject, or reading his book[1].
There are lots of people with doctorates who give talks, many of which contradict each other.
What we know is that:
- the common dietary pattern isn't working
- many more "primitive" diets show better results
What we don't know is exactly which aspects of a primitive diet are so beneficial relative to modern diets. A general pattern is that foods which are digested quickly tend to be overrepresented in modern diets. Foods which are easy to digest tend to be more pleasurable than foods which are slow to digest because our bodies like to save energy whenever possible, but our body is also configured "with the expectation" that food will be sort of hard to digest. I bring this up not to propose my own dietary remedy but to suggest that there is likely to be a trade-off between pleasure and health, and while careful study of nutrition can help us reduce the hedonic cost of healthy eating, it is not likely to disappear.
In fact, the neural pathways associated with hunger and satiety are implicated in the pathophysiology of diseases associated with overeating; this is discussed in one of my favorite reviews of the subject -- "Limitations in anti-obesity drug development: the critical role of hunger-promoting neurons"
I'm not appealing to his authority—you should review the scientific literature he cites. Also, I cannot recommend enough actually trying out different diets to see what personally works best for you. I would be very interested in hearing about your living by the recommended "Daily Dozen" [0] for a month, to see for yourself how fantastic it will make you feel. Also, I would recommend checking out The China Study. [1]
I have already learned to ignore anyone who seriously cites "The China Study". The Wikipedia article even has a warning at the top:
>This article may present fringe theories, without giving appropriate weight to the mainstream view, and explaining the responses to the fringe theories.
>I'm not appealing to his authority—you should review the scientific literature he cites.
This is still an appeal to authority -- different researchers will cite different literature, etc. I've devoted many hours of my life to reading scores of scientific articles on nutrition, and one thing I've learned is that anyone who thinks they've discovered the one easy trick to eating healthy is trying to sell you something. There's always contradictory evidence.
For example, one central claim of "The China Study" -- it's been cited at me at least a dozen times in the last ten years -- is that IGF-1 is, like, totally evil. However, there are also problems associated with low IGF-1:
It seems unlikely to me that such oversimplified explanations of how metabolic signalling works are going to promote understanding that leads to better eating.
I didn't realize there were issues with it—it's been forever since I looked at it. I added it as an afterthought, rather than seriously citing it, but that was laziness on my part and I am ashamed of myself and do humbly apologize. However, I take issue with somebody completely ignoring anybody for any arbitrary heuristic—that is also intellectual laziness.
I do appreciate your well-reasoned response, and respect the amount of nutritional research you have done. I merely recommend trying Dr. Greger's nutritional advice for yourself for a month, to see if it personally works for you. Following it plus reintroducing exercise to my life each played a large part in breaking out of a major depressive episode.
In the end, what matters is finding what works for us personally. I have no vested interest in convincing anybody to follow my nutritional advice, other than wanting them to flourish. I'm sorry for accidentally butting heads, I seem to have rubbed you the wrong way. Hope you have a wonderful day.
Seem like two sides of the same coin. It's replacing a good thing with a bad thing. Government agricultural subsidies benefit sugarcane and corn production, resulting in fewer vegetables and more sugar.
Hormone just means any type of signaling molecule produced by your body. So no vitamins are in anyway similar to hormones. There are also hormones you can live without, so not all are required.
The carbs hypothesis doesn't really hold up once you look around the world. There are groups of people such as the Hadza and the Mbuti who derive an enormous portion of their calories from carbs/sugar and show none of the issues Americans deal with: obesity, insulin resistance, etc.
From what I've read about these hunter-gatherer societies - they don't have a calorie surplus, and they experience periods of fasting that probably improve their health.
In developed countries, I think that the availability of food combined with low satiety from carbohydrates creates a positive feedback loop.
There's also time-restricted eating. In mouse models, 2 mice with the same bad diet (high sugar, high fat), but one eating during a 12 hour window and another eating any time, the 12-hour window mice staved off conditions like diabetes much longer.
So it's not only what we eat, but "when" we eat as well.
That's a pretty silly perspective. If the idea is that high-carb diets are universally bad, a counter-example falsifies that notion. It may be that high-carb low-exercise lifestyles are bad. But you need to refine your theory to account for the fact that there exist large groups of people with high carb diets who do just fine. You don't just get to dismiss it.
I'm not even sure what that statement means. Are you saying that there is no standard effect of a consistent diet on health? That humans eat different stuff? You seemed to be trying to suggest that contrary examples of people eating lots of carbs but not having negative health consequences was somehow irrelevant to this debate.
I disagree. I believe that the core of these problems are carbohydrates. Insulin spikes from carbohydrate consumption cause fat retention. Sugar doesn't create satiety, so it compounds eating.
The "it's an over-eating problem" fallacy keeps getting introduced by sugar companies. It happened in the states, then moved to South America, and is currently hitting India [1]. It's a playbook by the sugar industry that echoes of the tobacco industry's old tactics.
Suddenly, societies that have maintained healthy BMIs for thousands of years are having obesity problems as sugar gets introduced. They didn't develop gluttony overnight - it's a sugar problem.
This guy lost 27 pounds eating your "weaponized carbohydrates." The thing is you have fallen hook, line, and sinker for people and groups that make money off of selling you books and info about "weaponized carbohydrates."
Is sugar overconsumption bad? Of course. That doesn't mean that we have to begin breaking the laws of physics concerning calorie intake to justify it.
I mean, can't you both be right? I doubt the OP was indicating that any amount of sugar automatically and magically makes you gain weight.
You can diet off of pure sugar if you want. Calories in, calories out. I doubt anyone denies that. Weaponized carbs is akin to drinking a beer vs hard liquor. Sugar gets pushed into everything, you like it, you eat a ton of it, and eventually you run into massive problems.
I think the weaponized carb idea is correct. Carb's aren't inherently bad, but when you take out ability to be sated from carbs, when you take out fiber from the carbs, removing natural barriers to consumption, when you refine it to pack in more carbs per weight.. all these things start becoming weaponized carbs. We're refining a drug.
Your reply also ignores sudden climbs in carb related problems. Eg, the India article that the OP linked. Your reply seems to suggest that suddenly, for no reason, India is just wanting to over eat. This over eating trend has been caused by something.
Modern junk food with massively refined carbs seems likely to blame.
I'd love to see his A1C measured before and after that experiment.
Conservation of energy is basic physics. The relevant questions are whether a normal person has satiety on 1800 calories of sugar, and whether the metabolics of sugar are different than other sources of energy [1].
You reply with an accusation of falling prey to a supposed vast group of profiteering researchers and support it with one anecdote?
The body is sufficiently complex that some people smoke cigarettes for 40+ years and still manage to die of something that isn't respiratory related first.
By "nobody" I meant "nobody representative of a noteworthy population in statistics".
Even if you do not trust the scientific consensus regarding nutrion (all recommend fruits (sugar) and vegetables, most recommend a whole food plant based diet, most warn against a high fat diet, most warn against animal products in large quantities) there are other reasons for avoiding animal products:
- Ethics. An animal is a sentient emotional being. Like a human.
- Destruction of the environment. E.g. waste of food by feeding animals, deforestation, water pollution, greenhouse gas emission.
Not debating any of those points, only that sugar and junk food makes you hungrier and therefore harder to diet. There is an obesity epidemic that seems to be getting worse. I'm more interested in that problem.
Some of what you describe can be attributed more to factory farming which I generally disagree and personally don't buy.
Animal products aren't expensive if you compare calories per dollar.
I am certainly not saying steak isn't more filling but just a random anecdote. As a dieted down currently lean person I ate 4000-6000 calories (all weighed to the gram) of steak/ground beef a day for a month no problem.
This was sufficient to gain a substantial amount of weight in that time. But figured id try the meat only thing being talked about in the last year on myself.
Have you been to a restaurant in the US? Food portions are ridiculous. Even a fast food meal has 1200 calories. A sit-down casual dining place will give you > your daily allowance in one meal.
Our drink and appetizers sizes are enormous. It's disgusting.
I think an interesting direction to take reading up on the subject is instead of it being the spread of sugar look into the spread of industrial seed oils and how much their intake has increased.
Sure but it's not a uniquely American problem. Some other countries are even worse, and others are catching up fast. In a few decades this will be a worldwide issue.
If you eat something that even remotely resembles a healthy diet, you probably don't have micro-nutrient problems anyway. You might be obese, but you're getting your vitamins.
I used to wonder if I should take a daily multi-vitamin. For unrelated reasons (weight loss), I started tracking my food intake in MyFitnessPal. MFP reports on calories, macros, and micro-nutrients... and I was shocked to see that my regular, reasonably healthy (I'm not a health food enthusiast, but I don't just eat big macs either) diet gave me way more than 100% of my recommended daily allowance of pretty much all the vitamins and minerals tracked in MFP.
As other's have commented you've really fallen for it, yet despite your strong convictions, it's not clear that you understand basic biochemistry:
> [Vitamin D] is so important that it is closer to a hormone than a vitamin.
The difference between a vitamin and a hormone has nothing to do with importance. In fact, the article that you linked explains it so plainly that maybe you'll reconsider your authority on the subject and not present opinions so "unequivocally".
> Vitamin D is not technically a vitamin, ie, it is not an essential dietary factor
Perhaps it excludes Vitamin D on purpose because it isn’t being criticized. Though it actually does mention it near the end, in the context of a soon to be released study.
I'm trying to be as healthy as I possibly can be. I do this with a ketogenic diet, fasting, jumping rope, stretching, and trying to get enough sleep. I also take a lot of vitamins. I did it by evaluating them one at a time.
But at some point, maybe it's too much. So I'm taking the idea of "email bankruptcy" and starting a "supplement bankrupty." So, at some point this year, I'm going to stop taking everything, see how I feel, and then reintroduce supplements again one at a time. I don't know if this is a good idea or not yet, but hopefully it's helpful, so I thought it was worth saying here.
What are you taking? I cycle keto, do IF (with 3-5 day fasts a few times per year), lift heavy, etc. I've greatly reduced my vitamins to just vitamin D and a probiotic. It's really nice not throwing back a ton of pills throughout the day. In their place, I focus on eating more green vegetables, I take a greens drink, and Udo's oil (omegas) and drink a ton of BCAAs throughout the day. Feel much better than when I had 15 different pills.
Many supplements do not actually fill the most common deficiencies. (Either due to lack of or insufficient amounts of the active ingredient.) Vit. D, B12, magnesium and potassium are most common in western world. Depending on the kind of salt or algae you used iodine might be a minor concern.
More rare but also high impact are folic acid metabolism problems which require specific forms of folate. (There are reliable genetic tests for this.)
And most important part is that in older people impairment of metabolism can go either (worse absorption/production or clearance) way making RDA not reliable as it was calculated on healthy people.
"Many supplements do not actually fill the most common deficiencies."
I am someone who actually needs supplements. I have at least a moderately bad case of Celiac disease, the one that everybody knows as "that disease wot gave us all those gluten-free freaks", but is much lesser well-known as being a disease that makes it so the digestive system is not as good at extracting nutrients. I have experienced, diagnosed, and corrected several deficiencies in myself over the years. (Sometimes I feel like I have to pack my digestive track with nutrients the way one has to pack a black powder pistol... get in there, you stupid nutrients, tamp tamp tamp...)
So unlike someone who is just sort ambiently taking nutrient supplements in the vague hope that maybe they'll be helpful, I have actual symptoms to compare them against and see whether they address the issue.
So I can tell you with great confidence that there are a lot of very bad supplements out there. What you find in the grocery stores may be worthless. What you find in speciality stores may even be worthless. Fortunately, you can usually find things online.
Several people here have mentioned magnesium deficiencies as being one of the common ones. Unfortunately, if you just walk down to your local drug store and buy magnesium supplements, what you'll get is magnesium oxide. Fans of chemistry may recall that oxygen binds pretty tightly. I don't know exactly how bioavailable that is, but I can certainly attest that when I switched to the chelated magnesium you can find online and nowhere else I've seen, I saw huge differences very quickly. Trying to supplement magnesium via magnesium oxide seems to be about as successful as trying to supplement your iron by eating iron oxide. Won't work.
The drug store also stocks a lot of supplements that use a lower-quality or less bioavailable version of whatever it is. Vitamin D seems to have gotten enough attention that they mostly stock the good ones now, but a lot of the other ones verge on worthless too, despite their labels claming to have 1000% of your RDA.
The good news is that you can find good stuff if you look hard enough. The bad news is that it can take some time and effort. The weird news is that often the good stuff isn't all that much more expensive. Do you want to spend $7 on something that doesn't do squat or $9 on something that does? The former is hardly a savings....
Anyway, I would say to anyone who does feel like experimenting, do a bit of research and at least try with something that may actually work. The data is useless otherwise.
What was your experience with Magnesium aspartate such as found in ZMA (https://en.wikipedia.org/wiki/ZMA_(supplement))? Most of the research I saw was that this would work fine in terms of actual absorption.
This is one of those facts that sounds scary but it's really hard to interpret. Prostate cancer is extremely common; I've heard that upwards of half of men that die of old age have developed prostate cancer, though not all have gotten to the point where it's been noticed and diagnosed. A quick google says that 1 in 7 men will be diagnosed with it.
So on the surface it sounds like the vitamin will kill you, but in reality what if it's helping enough that you're now living long enough for the prostate cancer to actually become a problem? What if people that take vitamins are more health-aware and more apt to get regular physicals, increasing their "occurrence" of cancer?
There's a lot of variables that the article doesn't discuss and I'm not confident they have been controlled for.
Hmm that’s interesting. I’m on 1g of B a day (neurobion) for herniated disc. That’s quite a lot; most supplements do about 50mg of B. This warrants more investigation.
B is divided into different forms. Some of them you can take a lot of (e.g. B12), while others you should be careful with (e.g. B6). I suggest you do some research.
Unfortunately, the FDA has undergone regulatory capture to a significant extent -- more from the pharmaceutical companies than from the supplement manufacturers, including the former trying to use political influence to kill off or capture the latter.
And universities and their programs have become increasingly dependent upon and so captured by commercial dollars for funding.
So, we need science to help sort this out. But at the same time, our practiced science is becoming more political, commercial, and biased.
P.S. We also need science to say "we don't know" instead of "we don't have a scientific explanation, ergo it's bollocks".
Last winter I got five colds, each lasting two to three weeks. The winter before that, I got four, and every winter I can remember before that I got three colds. Two winters ago I tried an experiment. I washed my hands religiously and didn't touch my face at all. I had hand sanitizer with me at all times. It didn't help at all. I asked my doctor what to do and he said wash your hands.
Last fall when the cold season started I got a cold. Around the time it went away I started taking 200mg vitamin C every night before bed. I have not had a cold since. This might be anecdotal but I am now a big believer in vitamin C.
vitamin C daily, plus, good hand/face practices, combined, have correlated with a huge drop in the rate I get colds/flu/sinusinfections/pinkeye. for me, these are all nearly zero now. and I always weigh first-hand direct experience much higher than any academic theory or random stranger's arguments on the web. I'm sold.
I was walking in Manhattan at a pretty busy corner, and noticed this supplement store. Typically they're filtered and you forget you ever saw it. But I couldnt help but think about the amounts of pills or supplements this store had. The various varieties for any kind of "need" one might have. How was it selling enough to rent real estate...
I wondered how do people by this stuff believing it helps them (as opposed to the usual remedy of sleep, exercise, and good diet). Than I asked my self, maybe I'm missing something! Should I be taking supplements too?
These stores do just fine. They prey on hypochondriacs and people who believe they have a special condition or are in on some sort of health secret. The vitamins are mostly harmless and come in colorful plastic packaging adorned with outlandish but noncommittal promises.
Each type of supplement comes at a range of prices. There's the cheapo which no one expects to work and few people buy; it's there so you feel good about the higher priced item your about to purchase. Then there are a handful of mid priced supplements. These are the ones people actually buy. They are also tiered so the store can capture the price point of the varied economic classes of its patrons. Finally, come the ridiculously over priced uber strength supplements. They have price tags starting around $80 and heading into the hundreds. Only fanatics and the most gullible dupes actually purchase these. Their main purpose is to make you feel like the money you blew on gelatin, starch and lactose was well spent.
> I wondered how do people by this stuff believing it helps them
Read Amazon reviews. It's pretty amazing what people can come up with.
I take the usual suspects: Magnesium (I run almost every day) and a Omega 3/Vitamin D combo (I don't eat fish and we don't get a lot of sun here in northern Germany). Seems like a reasonable thing to be doing but I can't for the life of me tell any difference with or without them. I do buy the cheap ones though - maybe I'd feel 10 years younger if I'd buy the top shelf ones...
I read that 1 in 6 Americans have an autoimmune condition. I'm not sure if it's true however if it is that may explain a lot of this. Often autoimmune condition treatments include non-mainstream diets that can be extreme and therefore require supplementation.
Half of the stuff in a supplement score is either too specific for the general population or just plain BS (protip: the more over the top the name is - I dunno, "Drol-mass-max" or something - the more BS it is)
Then you have the dietary macronutrient supplements (Protein, Omega 3, etc), the multivitamins and the specific functional foods.
Your "good diet" is probably lacking some micronutrients (some websites or fitness trackers allow you to set your diet and they will show exactly what's missing related to the guidelines) so I'd rather go with multivitamins (or at least Vit D)
Precautionary principle. When we are taking supplements, we are really playing the odds.
And the odds are that there will be side effects. What side effects and how many people will be affected is the question. That's because it's hard to pinpoint the interactions between substances in the supplement and what's in the body. It's all the more difficult to see the second and third order effects that might happen.
My principle, taken from NN Taleb's work is try not to take anything unless you are really sick. It's really a thumb rule, more than anything.
Dr. Valter Longo, who has been researching the fast-mimicking diet (also autophagy and longevity) says you're probably safe taking vitamins every 3 days. Because that should minimize or eliminate potential long term damage of the vitamins while also ensuring you don't become deficient in certain vitamins. Sounds pretty reasonable to me.
In a previous HN thread some were mentioning that "Vitamin E causes cancer" study. But it was over a 12 year period and the people were taking like 15x the RDA dose every day. And even then I think it only increased the "chance" of cancer by like 20% (I may be not be remembering that part right, though).
Tip: try to lower your carbs intake to below 30-40 grams/day. My hay fever disappears after 3 days of low-carb diet (I tried this diet just for fun, and now I skip carbs for 2-3 weeks every spring and I don't need antihistamines at all.)
Sorry, also anecdata, but I've experienced a similar result. Was on daily allergy pills, eye twitches during allergy season, that sort of stuff, and started a low carb diet, my skin cleared up and I stop being so damned itchy.
I suspect it's because the diet eliminates some foods that I'm allergic/sensitive to (how could it not with how many foods it necessitates cutting out?), so the causation might not actually be the low carb diet, as some vegans claim a similar result. In that context it stands to reason that both sets of dieters are finding existing sensitivities and chalking up the gains to the diet. I found out that for me glutamate, both from natural and artificial sources, causes substantial headaches, which is a bummer because I love bone broth. Beans also give me restless legs at night.
So while it's hard to be absolutely scientific in your everyday life, it doesn't mean it's impossible to glean any sort of improvement in your health and well-being through personal experimentation.
> So while it's hard to be absolutely scientific in your everyday life, it doesn't mean it's impossible to glean any sort of improvement in your health and well-being through personal experimentation.
This is something I'll always be grateful to the equal parts brilliant and crazy, late Seth Roberts for teaching me.
It is not about eating right but eating right every day that makes it hard. The way vitamins work is that you need them every day which is why there is a daily recommended percentage of all our foods. Which is why it is still a good idea to supplement with a vitamin tablet.
Who is funding all these studies about vitamin supplementation? It's clearly not vitamin manufacturers or they'd never be published, but who else has an interest in the outcome?
> It's clearly not vitamin manufacturers or they'd never be published
Do you honestly believe that or was that cynical? Probably not directly but the vitamin industry is a big industry and it's in their interest to promote taking supplements.
Considering that the article lends the reader to understand that studies are indicating vitamin supplements are not as necessary as we'd like to believe, I don't think op was being cynical.
Random quote from the article:
> I faithfully chewed those calcium supplements, and then a study said they didn’t do any good at all,” said Ms. Bentley
So what is one to do? IMHO, the best one can do is to persevere and try to survive the best they can. One way of doing that (and I think a very productive way) is to be a scientist of your body and try different things. For some exercise works, for some vitamins, for others a certain type of diet.
I will not judge another for trying to take care of themselves as best they can. However, I will judge against how scientific they are about doing so to a degree only to critique their methods in hopes they can reach a state of reasonable comfort if they havent already obtained it.
Spend an afternoon reading examine.com. Follow the studies. Read conflicting studies. Read about placebo. You will see that these supplements do help a significant portion of the populate for condition X. Not everyone though and likely because conditions X is really a superset of conditions X0, X1, ... XN. Until we can elucidate condition X into its true subcomponents, I think Americans will continue to seek their supplements.