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The Experts

Another dig at complementary medicine

Dr Ross Walker
Monday, July 22, 2019

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A study published recently in the well-respected journal, the Annals of Internal Medicine was titled: “Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes: An Umbrella Review and Evidence Map”.

The conclusion of this trial stated reduced salt intake, omega-3 PUFA use and folate supplementation could reduce risk for some cardiovascular outcomes in adults. Combined calcium plus vitamin D might increase risk for stroke. The headlines were released stating:

“Vast majority of dietary supplements don't improve heart health or put off death, study finds.”

Basically, the theme of the study was that there was no real benefit for the vast majority of supplements and, in most cases, these supplements have no place in the management of cardiovascular disease. This is yet another large trial that will warm the hearts (so to speak) of the conservatives in medicine who want everyone to believe all that works is a prescription pad or scalpel.

But when you read the study very carefully, there’s no mention in the body of the study about the vital aspects that will tell you whether this information has validity. I reviewed the entire article, including the appendix and it was only there that I found the average follow-up for these trials. I have included the table below noting that the authors purely gave average follow-up times that could vary between six months up to the very longest of 10 years. They didn’t specify which of the particular trials they examined fitted into any of the follow-up categories (i.e. short or long-term trials). They did not specify whether the vitamins used were synthetic, naturally sourced, or the dose, or whether the vitamins were used alone or in combination. There was also no specification regarding the type of people in whom these supplements were used i.e. primary or secondary prevention.

Primary prevention is where a person does not have the disease and you’re trying to prevent it. Secondary prevention is where the person has already suffered an event and you are trying to prevent further events. People in the second category typically have a much greater disease burden and the chance for further events is much higher. If any reader of this study wanted this vital information, then you’d have to review each individual trial of the nine systematic reviews and 4 new RCTs selected that encompassed a total of 277 trials, 24 interventions, and 992,129 participants. A total of 105 meta-analyses were generated. 

We will hear all the usual claims from conservative clones, supported by the findings from this very large review suggesting there is no evidence for the benefits of supplementation: “if you follow a standard diet, you are obtaining all of the micronutrients necessary without supplementation, and that complementary medicine is useless or in some cases may even cause harm.”

There are always the demeaning comments that all vitamins do is give you expensive urine, and that they are recommended by charlatans.

A few years ago, an Australian TV show, Four Corners, presented a segment on US complementary medicine companies that showed very clearly that (most importantly, US) complementary medicines are made to food standard and not pharmaceutical grade. A study of 300 different products demonstrated the vast majority had contaminants and the ingredients written on the bottle were not actually in the tablets or capsules.

However, Australian supplements are made to pharmaceutical grade and are under strict regulation. There are no contaminants and the ingredients written on the bottle are actually what you get.

(This is the first article in a series of three. Check out the second tomorrow on this website.)

Published: Monday, July 22, 2019

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