Wednesday, December 19, 2012

Are Dietary Supplements and Multivitamins Addictive?

The Merriam Webster dictionary definition of addiction is a "compulsive need for and use of a habit-forming substance characterized by tolerance and by well-defined physiological symptoms upon withdrawal; broadly: persistent compulsive use of a substance known by the user to be harmful."

Psychology Today defines it as "a condition that results when a person ingests a substance (alcohol, cocaine, nicotine) or engages in an activity (gambling) that can be pleasurable but the continued use of which becomes compulsive and interferes with ordinary life responsibilities, such as work or relationships, even health."

Pursuant to such definitions, one who takes multivitamins and supplements would not classically be deemed an addict because he or she doesn't know that such pills may be harmful and typically would not experience physiological withdrawal symptoms from the use of such products.

Yet, I would like to offer an alternative definition of addiction.  My definition is the compulsive use of a substance in the absence of any evidence that the product enhances health or that it is not harmful. Furthermore, my definition includes the use of such a product as a crutch and substitute for otherwise engaging in healthy behaviors such as a health promoting diet, physical activity, stress management, etc.

Under my definition, we have an epidemic of supplement addictions in the U.S.

Over the past year, I have been giving lectures to over a thousand people on why supplements and multivitamins are mostly worthless and may be harmful. Yesterday evening, I gave this presentation to a group of about 70 people. As often happens with this lecture topic, I was peppered with questions both during and after the presentation.

Despite citing specific very large studies that demonstrate potential harms related to the use of such products, I was asked repeatedly if there was definitive proof that taking such products is absolutely harmful. One audience member went so far as to state that she had been taking such products for years and had suffered no apparent harm so why was I certain in my pronouncements. Certain audience members shook their head in agreement challenging me to refute this apparent fact.

As the intensity of the pro-supplement voices rose, I took a deep breath, composed my thoughts and answered as follows. First, I reminded the audience of Mark Twain's quip that "It's not what we know that gets us into trouble. It's what we know for sure that does." I explained that that I could not state with absolute certainty, given the biological diversity of people, that all multivitamins and supplements were equally worthless and/or harmful to everyone.

People have different medical histories, use different prescriptions, engage in different lifestyles, eat different diets, and have different genetic predispositions. Such diversity often challenges and complicates the application of research results to any given individual. Furthermore, some people may actually suffer from a deficiency that for one reason or another can't be addressed simply by regular food. By the way, this is extremely rare.

I also explained that sometimes the evidence of harm can be many years in the making. The development of a mesothelioma, a cancer, may not be evident until thirty years after exposure to a single strand of asbestos. Also, many of the diseases that afflict most western civilization inhabitants such as heart disease, stroke, dementia, etc. do not develop for many decades after steadily engaging in unhealthy behaviors. Even most sugar addicts and cigarette smokers don't develop diabetes and lung cancer respectively for many years of use. (True, some never develop it.)

Yet, something more nefarious was underfoot. I felt like I was suddenly challenging certain people's religious or political beliefs. There was palpable angst in the audience. Then it hit me. Instead of sharing my facts about such products, I should be asking questions.

"Hold everything," I said to the audience, "Why has the burden fallen on me to produce evidence that such products demote health, are harmful, shorten life, etc.?" I further queried, "Why are you not demanding proof of benefit and of no harm prior to spending your hard earned money on products that offer no such evidence?" Why are you blindly following advice from people who have a pure profit motive in getting you to buy their products?"

I shared with the audience an encounter three weeks prior at another such lecture when a Shaklee representative (Shaklee is a multilevel marketing supplement distributor) chimed in from the audience that based on a landmark study it performed, Shaklee offers such proof that it's products are worth the money spent on them.

I've since obtained the study to which he was referring. It is a ridiculous study confabulated by Shaklee to produce desired results. Basically, Shaklee compared selective data they gathered from their affluent product users to data collected by the government from many poor and elderly citizens.  It is not a valid comparison and the study was essentially a worthless (not for Shaklee) piece of marketing propaganda. No surprise there.

The bottom line is that the supplement industry has sowed so much confusion that even doctors no longer know which products are valid, when they are necessary, how much to recommend, etc. As Consumer Reports published in September 2012, there are now 55,000 products for sale and over $100 billion of nutritional products sold each year.

The weight and consistency of the marketing has been so effective that people are no longer asking the most basic of questions. Will this product help or hurt me? Is there any scientific validity to the use of this product for the reason I am taking it? Is it worth the money I am spending?

Since 1994, the law of this land is that supplement product companies need offer no proof of effectiveness to market their products--and so they don't. But like lambs to the slaughter, people continue to line up sheepishly and buy millions of these pill bottles of uncertain value. It is estimated that somewhere between 50 to 80% of Americans now take one form or another of supplement.

The value of these products, now occupying only 80 years of our 150,000 year chronicle (millions more if you include early man), may be the single biggest hoax in mankind's history.

Taking invalidated, potentially harmful supplements may not seem like an addiction to you, but it sure does to me.


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