Science Vs - Vitamins & Supplements - Are They Worth It?

Episode Date: October 19, 2017

Americans spend billions of dollars on vitamins and supplements, but are they worth it? We look at the science behind some of the most popular supplements with nutritional epidemiologist Prof. Katherine Tucker, neuroscientist Dr. Simon Dyall, and medical researcher Dr. Mark Bolland. Our Sponsors: G Suite | WP Engine Credits: This episode has been produced by Wendy Zukerman, Heather Rogers, and Shruti Ravindran. Production assistance from Rose Rimler. Our senior producer is Kaitlyn Sawrey. Edited by Blythe Terrell with help from Alex Blumberg. Fact checking by Michelle Harris. Sound design by Martin Peralta and Bobby Lord. Music written by Bobby Lord. An extra thanks to the Zukerman Family, Joseph Lavelle Wilson, Chris Giliberti, Jasmine Romero, Matthew Nelson, Stevie Lane, Dr Harri Hemilä, Stephanie from the New York State Library and Dr Rajaprabhakaran Rajarethinam. Selected Reading:The history of fortified foodsThe Institute of Medicine Report on calcium and Vitamin DSurvey on vitamin shopping habits in the USSimon’s paper on Omega 3 and spinal cord injuries in ratsMark’s work on calciumThis whopper of a study on multivitamins Check out the full transcript here: http://bit.ly/2rlrpnZ Learn more about your ad choices. Visit podcastchoices.com/adchoices

Oh, here it is. This is it. The vitamin aisle. Vitamin A. Vitamin B6. Multi plus omega. Multi for her. Plus omega.

Multi for him. Plus omega. Oh, we're in vitamin C land. This is fish oil land. Isn't it funny when you start reading the packets, you're like, do I need that? Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet Media,

the show where we pit facts against... Gummy fish oil! On today's show, vitamins and supplements. The vitamin and supplement industry makes billions of dollars each year, telling us that we'll live longer, healthier lives by popping their pills. So, senior producer Caitlin Sori and I thought we'd check out the claims at the pharmacy. Ooh, enhances the immune system. Supports natural energy levels.

Sounds like you need some of that. I definitely do. Hey, Katie, look, I found one for your mum. Supports flexibility. Helps lubricate and protect joints. That's what your mum needs. But what is the best science on how helpful these products really are? That's what we're going to dive into today. We're going to answer the following questions. One, how do scientists set that number for how much of each vitamin we need every day? Two, are there any benefits to taking vitamins and supplements?

And three, are there any risks to popping these pills? And if our trip down the pharmacy aisle told us anything, it's that there's a lot of these vitamins and supplements. So for today, we're going to focus on some of the most popular. Vitamin D, calcium, fish oils and multivitamins. When it comes to vitamins, there's lots of adult gummy fish oils. But then there's science. Science vs Vitamins is coming up just after the break.

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What does the AI revolution mean for jobs, for getting things done? Who are the people creating this technology, and what do they think? I'm Rana El-Khelyoubi, an AI scientist, entrepreneur, investor, and now host of the new podcast, Pioneers of AI. Think of it as your guide for all things AI, with the most human issues at the center. Join me every Wednesday for Pioneers of AI. And don't forget to subscribe wherever you tune in. Welcome back. Today, we're diving into the potential benefits of vitamins and supplements. But first, a story from the high seas. You see, we need vitamins in our diet, and the story of how we came to know this was, well, pretty gross. 500 years ago, sailors set out on these long sea voyages, and people started to notice that this wasn't particularly good for them.

They'd get this weird disease called scurvy, where sailors would bleed uncontrollably from any exposed cut. In 1596, a British surgeon that saw a bunch of these poor sods wrote that... The gums were rotten to the very roots of their very teeth and their cheeks hard and swollen. Moreover, they were full of aches and pains with many bluish and reddish stains or spots. That's pretty good. I think you went Scottish on a couple of words there, though. It's hard for me not to. This, by the way, is Scottish born and bred Gimlet producer Matthew Nelson.

But back to bleeding uncontrollably and scurvy. No one knew why these poor sailors were getting so sick. That was until the 18th century, when a Scottish physician named James Lind realised what the problem was. These sailors weren't getting enough citrus fruit in their diet. And then he was like... Eat an orange, you wee bastard. LAUGHTER LAUGHTER

And it wasn't until the 1920s and 30s, Chewy bastard. And it wasn't until the 1920s and 30s before scientists singled out the magical ingredient in citrus fruit that protected sailors from scurvy, vitamin C. And it was around that time that scientists were finding that other vitamins in our diet were linked to diseases, like rickets, which can give children bowed legs. That was linked to not having enough vitamin D. Too little vitamin A?

That could make you blind. And these were some huge breakthroughs. Suddenly, vitamins were everywhere and they were curing people from horrendous diseases. People were so excited about vitamins that they started adding them to our foods, like flour and dairy products. Vitamin D milk helps build strong bones and teeth. And Ralph has decided that it must be lots of milk which has given Linda such a bright smile.

Adding vitamins to foods made a huge difference. Fortifying milk with vitamin D helped lead to almost a complete eradication of rickets in the United States. And in this great vitamin age, companies quickly started turning vitamins into little pills and bottling them. And they were a hit. A magazine article from that time said that in 1937, Americans forked out almost $42 million on vitamins from the drugstore. But the messaging around vitamins shifted. And soon, they were no longer just protecting you from something like scurvy or rickets, but they were helping you live a better, brighter life. Still tired after a good night's sleep? Try Ributol. If you too need extra amounts of

thiamine and riboflavin, Ributol can help you gain new strength, new energy. And over the next few decades, the message went even wider. There were vitamins for women, vitamins for men, and vitamins for kids. And 10 million kids are getting all the vitamins they need to help them grow wider. There were vitamins for women, vitamins for men and vitamins for kids. And 10 million kids are getting all the vitamins they need to help them grow with Flintstones. We are Flintstones Kids. 10 million strong and growing. We are Flintstones Kids. And it wasn't just companies that were excited about vitamins. Scientists were too. They wanted to know if taking vitamins and supplements could protect you from diseases that you might get later down the line, like heart disease or dementia.

And that's kind of where we are today. Professor Catherine Tucker, who's a nutritional epidemiologist at the University of Massachusetts in Laos, says that science is ultimately asking. What are the amounts that are needed, not just to prevent deficiency, but to prevent chronic disease and keep us healthy and aging well? And that seems like it's a much harder figure to get at. Exactly. That's where we are right now. It's much more complicated. So on the back of your cereal box or a pill bottle, it might tell you how much of a particular vitamin you should take in every day. And what Catherine is saying is that that number is trying to do more than just protect you from scurvy.

It's trying to keep you healthy and aging well well. So, first question, how do scientists set that number? Because here's the thing, it isn't a perfect science. And to understand how tricky it can be to know how much of every vitamin we need every day in order to be healthy, we're going to look at the current debate over vitamin D. So maybe you've heard that we're experiencing a pandemic of vitamin D deficiency. Important news this morning about vitamin D. The CDC says some of us are not getting enough of it. You know that 100 million Americans have vitamin D deficiency. 100 million of us, including children.

Even Ludacris is worried about our vitamin D levels. But are so many of us really that low on vitamin D? Well, to know that, you'd have to know how much vitamin D we need every day to be healthy. And here's the thing. Scientists don't agree, and it's gotten feisty. There is a lot of animated discussion about that, a lot of disagreement right now.

And where does all that disagreement come from? Well, it kind of started with a crack team of nerds that were brought together several years ago by the Institute of Medicine. And they had one purpose. To destroy the world. No, of course not. It was to find out how much vitamin D we need every day. And to do that, they scoured through nearly a thousand studies. And these are studies

where scientists track people's vitamin D levels and also what kinds of diseases they get. And they whittled them down to the most important studies. And voila! They came up with a number that they reckoned keeps most people healthy. But some people say that number is too low and we actually need more vitamin D. Because here's the thing, there were a whole bunch of studies that that crack team of nerds didn't use to set the vitamin D magic number. These were studies claiming that vitamin D could help prevent cancer, heart disease, autoimmune disorders, diabetes and depression. In fact, the only studies that made the cut were about bone health.

So the nerds set a recommendation for how much vitamin D you should have every day based on that. And why did they sideline the others? Well, they said that all those other diseases could not be, quote, linked reliably or consistently, end quote, to taking vitamin D. But other scientists completely disagreed. And to Catherine, it kind of all comes down to one thing. And so there's a lot of people that are willing to accept lower quality evidence in order to say, yes, you should be taking a lot of vitamin D,

and others that are saying, we just don't know yet. And this debate might seem really academic, but every time you raise the bar on how much vitamin D you need, the more people who are seemingly healthy then become classified as deficient. Exactly. That's where we are right now. Conclusion. This back and forth over vitamin D supplements shows us how hard it is for scientists to agree on how much of a particular vitamin we need every day. And there's still a lot of debate

over how many of us really are deficient in vitamin D. As for what we need that vitamin for, well, we know it's good for our bones. As for that other stuff, reducing heart disease or cancer, we just don't know yet. But before you go popping vitamin D pills, here's something you should know. You can get your vitamin D for free from the sun. When UV rays hit your skin, it collides with a chemical that then triggers the production

of vitamin D. So going out in the sun is actually the most effective way to get this stuff. And that means no need to get ludicrous to fill your prescription. You could take Catherine's advice instead. Go out for like 10 to 20 minutes several times a week between the hours of 10 and 2 on a sunny day, and that should do it. But quick note, that advice might change depending on where you live in the world, what colour your skin is, darker tones,

need more sun, and the time of year. Also, sunscreen blocks a lot of UV rays, and that means you can't produce a bunch of vitamin D. It's something to keep in mind. After the break, we're going to take you through the top three vitamins and supplements taken in the United States and ask, are they worth it? What are the risks?

And will you regret not taking them. Welcome back. So we know if you're deficient in vitamins, bad things can happen to you. You can get bowed legs and bleed uncontrollably. Eat an orange, you wee bastard. But if you're not in that extreme position, it can actually be really tricky to know exactly how much of each vitamin you need every day. Still, lots of people paid lots of money for lots of different vitamins and supplements. So, what evidence is there for any of them? Are they doing some good? So, according to a recent survey of almost 12,000

Americans, the top three most popular vitamins and supplements are, in the third spot, fish oils, second place, calcium, and the winner is multivitamins. So, do you need any of them? Let's start with number three, fish oils. This is fish oil land. Gummy fish oil. And with Halloween just around the corner, should you be handing gummy fish oil out to trick-or-treaters? There is no candy tonight. OK, generally speaking, fish oil is packed with omega-3, which is a fatty acid, and our brain needs fatty acids to function properly.

But our bodies can't make omega-3 fatty acids, which means you've got to eat them. It's found in fish, flaxseed oil and walnuts. And scientists first realised the power of omega-3 when they found that people who ate a lot of fish had a lower risk of heart disease, dementia and Alzheimer's. So some scientists thought, aha, if fish is so good, what if you extract the omega-3 out of fish, pop it in a capsule, do you still get the benefits of eating the fish?

So we're going to look at that today and we're focusing on claims about the brain. Hi Wendy, my name's Simon Dial, Dr Simon Dial. Simon is a neuroscientist at Bournemouth University in the UK. He has spent his career studying omega-3 and says that once you take omega-3 out of the fish and stick it in a pill, it's not so easy to see its benefits. So it's very hard to sift through the literature and actually get a clear picture. So what do we know?

Let's first look at people who are already starting to go dotty. Say the early signs of Alzheimer's are already there. Can omega-3 help you? Probably not. A big review paper published last year found no convincing evidence that omega-3 could help people with mild or moderate Alzheimer's or dementia. And why is this? Well, it's thought that by the time you're showing symptoms, a lot of damage to your brain has already been done. By the time you're starting to show these memory deficits, it's probably going to be

far too late. But what if you start taking supplements before then, when your brain is doing just fine? Could it prevent damage? Well, Simon says, touch your toes. No. Simon says a review paper on a bunch of studies involving more than 3,000 older people, who all still had their marbles, found that popping omega-3 had no benefit on their brain function. But still, Simon says that this isn't case closed because to really know if omega-3 can prevent dementia, we'd need to follow a lot of healthy people for decades to see who gets dementia,

and then we'd need to figure out if omega-3 or perhaps something else in their diet made that difference. And this detective work is just really difficult. Studies in people are very messy. Studies in rodents, studies in tissue cultures, in petri dishes, they're much easier. And that's why Simon has done a bunch of studies in rats and petri dishes to see if omega-3 really is all that. In particular, Simon wanted to know just how much omega-3 could do to fight nerve damage.

So he damaged some nerves in rats. He cut through one side of the rat's spinal cord. Yeah, so the rats didn't really have a good time of it. And then Simon and his team injected omega-3 into their blood. A week later, he took the rats out and had a very careful look at how they walked. Rats are quite a sneaky little animal. They're very kind of good at hiding injuries because the injured rat tends to get eaten. Right. So Simon really wanted to see if the rats that got omega-3 walked better than those given a placebo.

And here's the thing. They did. So this was really quite breathtaking, the wow moment. When Simon's team looked at the spinal cord injuries under a microscope, they found that the omega-3 group had a much smaller injury. There was much less inflammation around the nerves. And other studies in rodents have found that omega-3 can potentially reduce inflammation in the brain, as well as neutralising a toxin.

On top of this, several studies in rats and mice have found that animals given omega-3 don't show so many of the hallmarks of Alzheimer's as those that don't get the stuff. So that's what we have right now, some really intriguing rodent studies. But is that enough evidence to stock the bathroom cabinet with omega-3? Do you take omega-3 tablets? I do actually take omega-3s, yes.

I take it to help preserve my brain. Simon seems to think it's worth it. And that's partly because he says the downsides of taking omega-3, as far as we can tell, are really small. The main issues you tend to have are tummy upset, so it's a little fishy aftertaste, a little burp when you take the capsules. Now, if you go online, the claims for omega-3 are bonkers. Science Vs. Senior Producer Caitlin Sorey asked Simon about it.

I was just like Googling some of the claims, right? So we've talked about cognitive benefits, but like there's some of this stuff on the internet, like weight loss, cancer prevention. Like like is any of that true? In a word, no. Basically, omega-3s are sold as a universal panacea. And that's kind of frustrating because there's a lot of good, sound, solid science behind omega-3s, but that's kind of lost in the message. They're just sold as this universal cure-all. Conclusion. We have some promising and consistent work showing that when rodents get omega-3s,

it reduces nerve and brain damage. But if you're not a rat getting your spine hacked into, as far as we can tell from studies in humans, there's no strong evidence that it can prevent Alzheimer's or dementia. On to the second most popular supplement in the United States, calcium. According to that big survey of almost 12,000 Americans, around one in ten take calcium supplements. And the one thing we've heard about calcium

is it's supposed to help protect us from osteoporosis and keep our bones strong? But one scientist started asking questions about whether all this calcium supplementation was such a good idea. Dr Mark Boland is at the University of Auckland in New Zealand. New Zealand. See if you can tell us apart. No one can ever tell Australians and New Zealanders apart. It'll be a little game while they're learning science. Yeah, you'll have to ask me lots of questions that got to do with six and sucks or fush and chips.

Okay, so if you haven't watched Flight of the Conchords, New Zealanders and Australians have very similar accents, except for a couple of words, like fish and chips. I say fish and chips. Mark says... Fush and chips. Did you hear it? Whatever. Let's just move on.

Back to calcium. Mark says that for years we've been thinking that if we popped calcium supplements, the calcium would go to our bones and stop them from breaking. Taking calcium supplements had become entrenched and all the guidelines recommended that people should take it. But in the 1990s, some large trials came out showing that calcium didn't stop people's bones from breaking. So Mark and his team decided to look at a whole bunch of studies, more than 40 of them. And they found, quote, evidence that calcium supplements prevent fractures is weak and

inconsistent, end quote. And later they wrote that their use in preventing osteoporosis should also be reconsidered. But there is a bit of nuance here, because Mark says that overall, calcium supplements might prevent some fractures, but just not many. So by treating 100 people for five years, you would prevent two people having a fracture. So you might think, well, that's not too bad. That's two people without broken bones out of 100. But then Mark's team found something else, something that made him want to nix calcium supplements from the medicine cabinet for good. And this finding got the media quite excited. Important news tonight for anyone who takes calcium supplements.

There is a new study that links them to an increased risk of heart attack. This is a dangerous new development. What is the problem here? His team's first study looked at more than 1,400 older women and found that those given calcium supplements were more likely to die suddenly and have a stroke or a heart attack than the women who got a placebo. Mark's team followed that up with a big review paper tracking thousands of older folks, and he found the same thing.

But, and this is important, while calcium supplements did increase the risk of getting a heart attack, not that many people in these studies actually got a heart attack. Oh yeah, the risks of heart attack and stroke are small. But Mark says that because the benefit of calcium supplements is tiny too, overall, he just doesn't think they're worth taking. Now, side note, you might have heard that you should take calcium not by itself, but with vitamin D to help your bone health.

Mark looked into this and he found that the combination didn't help much either. But, of course, not everyone agrees with Mark and his team. After Mark published his work, the National Osteoporosis Foundation, a leading body on bone health in the US, joined up with the American Society for Preventive Cardiology and they said that when it came to heart disease, calcium supplements, quote, should be considered safe, end quote.

Are they just totally disregarding your work? No, they're not totally disregarding it. They just disagree. And how can you disagree when there's data? Science is often about the art of science rather than there being an objective truth. Did you say the arse of science? Oh no, that's my thick New Zealand accent for you. No, the art, A-R-T. And so that's the interpretation of results is an art rather than a true science. So it is both the

art and the arse of science. I didn't quite catch your Australian accent there. OK, so the thing that Mark is calling an art is when, for example, you're pulling together a bunch of studies so that you can make strong conclusions about what supplements to take and what supplements not to take. Doing that can be difficult and reasonable scientists can disagree because you're ultimately deciding what's a good study and what's a bad study. So like do you throw out that study that

didn't consider people's diets or what about the one that didn't look into how much exercise they did? Or do you toss out that study that accidentally signed up a bunch of amateur rodeo cowboys. What you let in and what you let out can ultimately change your results. And just quickly, we've talked a lot about adults taking calcium supplements, but what about the kiddos? Well, a review paper found studies, quote, do not support, end quote, giving calcium supplements to healthy children. So if you were going to explain this to your seven-year-old, he said, Daddy, should I take calcium supplements? What would you say?

I would say, no, that would be a complete waste of time for you. Why do you ask? Conclusion. While there is some debate here, as best we can tell, calcium supplements with vitamin D or not probably aren't that helpful for keeping your bones strong and preventing them from breaking. And meanwhile, they might increase your risk of getting a heart attack, even if just by a little bit.

So finally, on to America's favourite vitamin. Multivitamins! Which, according to our big survey, one third of Americans are popping. People say you should take them, your kids should take them and you should feed them to your dog. Has Sparky lost his spunk? Has Lucky lost her luster?

It might very well be a vitamin deficiency. We know that eating a diet full of fruits and veggies packed with all sorts of different nutrients can help us live longer and prevent heart disease. But what happens when you extract out all those essential vitamins into one big pill? Well, here, Catherine, our nutritional epidemiologist, she's got some good news for you. Yeah, the multivitamins will not hurt you. A review paper published this year found that studies going on for 10 years find that multivitamins are safe to take. But if you want more out of your pill than that, like if you hope it'll help you live longer and

have a healthier life, well, here the news isn't so good. There's been some big studies that showed that they didn't really have a major effect. One huge thumper of a study recruited 14,000 older men, gave half of them multivitamins and half of them a placebo, and then followed them for more than a decade. And after all that work, it found no difference in the rates of heart attacks and heart disease between the two groups. And then when that research team looked at cancer,

well, men who took the multivitamins had a slightly reduced risk of cancer. But the researchers said that we shouldn't get too excited about this because other large studies have been really mixed. Still, Catherine isn't ready to piff out these vitamins just yet because she says that a few large studies that have looked into multivitamins have been done in doctors and they might already have really good diets,

better than your average Joe. So for people who aren't eating so well... I think it doesn't hurt to take a multivitamin for insurance. Conclusion. As best we can tell, multivitamins are safe to take, but there's not good evidence that they'll help you live longer either. And just quickly, it's starting to get colder in North America. Yay, cold and flu season!

Achoo! So, should you be popping vitamin C and zinc? Well, there is evidence that taking vitamin C and zinc lozenges could help you get over your cold a little bit faster. But there's not good evidence that it will keep you from getting sick in the first place. For example, a big review didn't recommend that the average person start popping vitamin C to stop them from getting a cold. And then what about everything else? When it comes to science versus vitamins and supplements, do they stack up? Are we in a vitamin D deficiency pandemic?

Well, that all depends on how you define deficient, and scientists are battling through that right now. They're even not sure exactly what vitamin D supplements would be good for. The best evidence we have suggests that it might strengthen your bones. What about omega-3? Well, if you're a rat with a spinal cord injury, then get onto that omega-3 stat. For the rest of us, well, as far as we can tell, there's no harm to taking them, even if the science at the moment doesn't really show that it helps. As for calcium, there's a big debate going on right now. It might prevent a few broken bones here and there,

but you've got to weigh that against the potential but small risk of heart disease. And finally, multivitamins. Well, again, the research here is pretty underwhelming. But the thing is, we know that vitamins aren't bull. We know that we need to eat vitamins in our food to be healthy, that's for sure, and we've known that for around 100 years. But if your gums aren't bleeding from scurvy

and your bones aren't verkuked from rickets, can vitamins and supplements help you live your healthiest, longest life? Well, it doesn't look like they do much. But studying this stuff is really hard. And even all the research we have can't tell us whether you, you listening, should be taking vitamins or not. And it's this gap in the science, this nagging question of, should I? Maybe it will help. Maybe I'll regret not taking it. That leaves room open for marketers to sell their wares to you.

And not just you, but your kid and your mum and even your dog. Has Lucky lost her luster? That's science versus vitamins. And if you want to get more information about this episode, you should subscribe to our newsletter. We put the transcript for each episode in there, including all our footnotes. And there's a lot of other fun stuff in there.

To sign up, head to gimletnotes. And there's a lot of other fun stuff in there. To sign up, head to gimletmedia.com slash newsletter. This episode has been produced by me, Wendy Zuckerman, Heather Rogers and Shruti Ravindran. Production assistance from Rose Rimla. Our senior producer is Caitlin Sorey. Edited by Blythe Terrell with help from Alex Bloomberg. Fact-checking by Michelle Harris.

Sound design by Martin Peralta and Bobby Lord. Music written by Bobby Lord. An extra huge thanks to the Zuckerman family, Joseph Lavelle-Wilson, Chris Giliberti, Jasmine Romero, Matthew Nelson, Stevie Lane, Dr Harry Hemmiller, Stephanie from the New York State Library, and Dr Raja Prabhakan, Raja Thinnam.

Next week, we're going to be working on some new stories, so there won't be a Science Versus episode. But then we'll come back with our investigation into what's killing the bees. Are we really in a bee-pocalypse? A world without bees is a world without blooming flowers and plants. We would still have food, but we'd be eating gruel. The stakes are high. Stakes are very high, yeah.

It literally is like Dorothy in The Wizard of Oz going from Oz to Kansas. I'm Wendy Zuckerman. Back to you next time.