Why I hate supplementsOn
In medieval times, relics were the thing if you wanted to stay well. Some opted for fragments of the bones of a saint, others preferred splinters from the one true cross. Less godly but equally gullible, we prefer supplements. Fish oil capsules and multivitamins are our relics, and they are every bit as effective as the bone and wood they displaced.
In a previous post (1) I debunked fish oil, now more or less abandoned by the Cochrane Collaboration and all those who swim with them.
The fish oil industry is worth about $12 billion per annum (2), and is worthless. The global market for multivitamins, at $25 billion (3), is even larger, and an even larger waste of money.
We’ve known this for some time. A decade ago, a set of studies and meta-analyses of ‘A-Z’ multivitamins and multi-minerals (4-8) concluded that these products do nothing other than enrich the companies that produce them. The regular use of multivitamins did not reduce the risk of cancer, heart disease, dementia or death in men or in women. More recently, another very large major prospective trial (9) and a huge meta-analysis (10) arrived at the same conclusion.
The poor design of these products reflects historical bias, and the fact that most of them are owned by drug companies (48) whose business model depends on vast numbers of us becoming chronically ill (48). Big Pharma has no interest in helping you to stay healthy with low-cost products. It is currently renting US politicians to re-position all supplements as licensed pharma products, which they will own and price accordingly (see below).
In the meantime, people who take supplements may claim to feel better (11) but objectively, in terms of health outcomes, they gain no advantage at all (11). They sicken and die in exactly the same way as non-supplementers. Total mortality is unchanged. Unless you take calcium supplements, in which case you may die earlier (ie 12, 13).
Bones and splinters, anyone?
The negative findings of these trials might seem counter-intuitive given that poor diet is established as the most important cause of early (ie preventable) mortality (14); and given that the post-transitional industrial diet is strongly linked to increased risk of degenerative disease and accelerated death (15).
The link is hardly surprising.
Ultra-processed foods have terrible nutritional values. They leave consumers overweight, low in most nutrients (ie 16), chronically inflamed, dysbiotic and metabolically deeply compromised. The human herd is being poisoned, by commission and by omission.
But if this is the case, why is the supplement industry so ineffective?
The sad truth is that the bulk of their pills and potions are very far off-target. The manufacturers are still claiming to fight deficiency disease, even though that war is over and will remain so until governmental idiocy makes food shortages fashionable again. Or, they are pushing the latest, most fashionable extract. And in both cases they are still thinking in terms of ‘magic bullets’, which means they are peering through the wrong scope.
Among the top 10 selling supplements you find vitamins D, C, B12 and K, the trace elements magnesium, calcium and zinc, and the vain hope collagen (17). All of these have one thing in common. They do not work. They fail to build bone, enhance immunity, make you beautiful or provide any health benefit. The A-Z formulations are manifestly no better.
Supplement manufacturers can’t see the forest for the trees, and planting a brace of trees cannot save a dying forest. You have to take an ecological approach.
Thanks to ultra-processed diets and low energy lifestyles, almost everyone is depleted not only in vitamins, minerals and phytonutrients but also methyl group donors, cyanogens, prebiotic fibers, CR3-agonists, omega 3 HUFA’s, the conditionally essential amino acids and sugars, and more. At the same time, they have too much omega 6’s, sugars and starches.
The resulting metabolic imbalances cause chronic inflammation, type B malnutrition, dysbiosis and glycemic mismatch. These four pathogenic systems drive degenerative disease, and accelerate epigenetic and symptomatic ageing. Magic bullets, whether pharmaceutical or nutritional, cannot rectify this complex mess. Each system can be countered, but each one requires a very specific pharmaco-nutritional approach.
For a simple analogy step off the sidewalk and into the street, because today’s consumers are like chronically under-maintained cars.
Multiple systems are compromised, and many points of weakness are moving inexorably towards breaking point. Countering any one of these can have no effect, just as topping up the windscreen wash will have no effect on your car’s performance. Car and consumer both need a full-scale overhaul, and proper maintenance. The impact of a single nutrient simply disappears into the checks and buffers of a badly skewed metabolome in which homeostasis is failing, and disease progressing.
This is why the pharmaceutical industry, which persists in aiming its magic bullets at the ghosts of diseases past, offers no cures; and why mainstream medical androids still dream of finding that elusive electric bellwether (18).
One example of the failure of classical models to provide useful insights into the relationship between diet and disease are the many studies that attempt to link intakes of different lipids with meaningful end-points. Do saturated fats or omega 6’s kill? Are omega 3’s protective? The data are a contradictory mess (19-32) because humans operate on fuzzy, not binary metabolic logic. These costly and pointless trials should be abandoned, but scientists plough on with the conviction that only the combination of academic tenure and pharmaceutical funding can provide.
If they were to look to the horizon for a moment they would surely see that the reasons why relationships between different types of dietary fatty acids and health outcomes are so unclear, and why changing any one of them makes relatively little difference, are quite obvious.
Nutritional pharmacology is unlike pharmaceutical pharmacology, a far simpler ecosystem in which xenomolecules are aimed at specific target enzymes / receptors. The metabolome (and hence our health prospects) is a stochastic arrangement in which multiple nutritional and other inputs (ie physical, social) interact with each other and with the host, which is itself dynamic, interactive and responsive, before typically producing a series of outputs which create feed-back and feed-forward loops to the metabolome and the individual’s diet and life-style.
Omega 6 fatty acids do produce largely inflammatory mediators, and omega 3’s do produce largely anti-inflammatory ones. However, the utter failure of omega 3 HUFA’s to generate meaningfully positive cardiovascular (or any) outcomes shows the futility of thinking of fatty acid metabolism and inflammation in first order terms. One must also consider chaperones, degrees of oxidative stress, 6:3 ratios, total polyphenol intakes and many other variables besides (ie 33).
Another prevailing error of thought from our venerable centers of groupthink learning is exemplified by the esteemed Larry Appel MD, director of the Johns Hopkins Centre for Prevention, Epidemiology and Clinical Research. Larry concedes that a pinch of folic acid is a good thing for women of child-bearing age, but vetoes all other supplements because ‘you can get all the vitamins and minerals you need from food’.
This is a profoundly unhelpful statement. Urbanites running at the average 2000 kcals/day cannot obtain all they need from even the healthiest diet (34). They are even worse off if they’re hooked on the ultra-processed food habit so aggressively promoted by the food industry, live in a food desert or have been left impoverished and demotivated in the dying embers of a culture drained by crony capitalism.
This is why public health is so poor, and getting worse.
In the land where Larry and his pharmaceutical brethren dominate healthcare, public health has declined significantly over the last 2 decades (ie 35). Fewer than 7% of US adults currently enjoy optimal cardiometabolic health (35); and Americans spend 2.5 times the OECD average on drugs (36). This is a sick, drug-dependent and dying population.
Larry is typical of his kind. I am sure he is intelligent, and I am equally sure, given his position, that he knows how to go along to get along. He knows which foods are healthy, where to get them and maybe even how to prepare them. But he appears not to know or care how the world turns, because what he is actually saying is, ‘Qu’ils mangent de la brioche’.
And what I am saying, I finally understand, is ‘Vive la révolution’.
Fortunately, revolution is coming.
The pharma model of medicine is failing, if only for medeconomic reasons. Due to our terrible diets and lifestyles nearly half of us acquire cancer at some point, but cancer patients are increasingly delaying or skipping medication because they can no longer afford it (37, 38). In the USA, two thirds of insulin-dependent diabetics are skipping or reducing their doses for the same reason (39). A third of Americans are unable to pay their medical bills (40). Medicare is tipping into bankruptcy (41, 42).
Revolution is coming. Many other social and political institutions which have long out-lived their original usefulness are also failing. Regulatory agencies have been coopted by the drug companies they were set up to regulate (43), political parties have been purchased by lobbying groups (44), social groups are deformed by virtue-signaling and the controlled echo chambers of the controlled internet.
Revolution is coming. The age of financialization, globalisation and waste as growth (planned obsolescence) will give way to an age of community and commodities where efficiency and durability will once again be prized, as they were prior to 1950. If the West does not finally spring Thucydides’ Trap and destroy the world to prevent anyone else from sharing it (45, 46).
Disease prevention via pharmaconutrition will be an important part of that necessary change. If you know how, it’s easy to become your own blue zone. We may walk in the shadow of the valley of death, penned in by the failings of the food, pharma and supplement industries, but the road to good health is short and straight (47).
To stop us from following this road, Big Pharma is currently sponsoring the Dietary Supplement Listing Act, to be included in the FDA Safety Landmark Advancements Act. If they can find enough corrupt politicians to support it (a rhetorical question), it will kill off the pharmaconutritional movement. If you live in the Empire of Lies, contact your senator and ask them to oppose this malignant legislation.
Next week: Where is Hoffa buried? And, how to cure knee pain.
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