An Article disputing the study on Multi-Vitamin and Women

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CRN Calls New Study on Supplements and Mortality " A Hunt For Harm "

PRNewswire-USNewswire

10-11-11

WASHINGTON, Oct. 10, 2011 /PRNewswire-USNewswire/ -- In response to the

published study, " Dietary Supplements and Mortality Rate in Older Women(1), "

published in the Archives of Internal Medicine (a publication of the American

Medical Association), the Council for Responsible Nutrition (CRN), the leading

trade association representing the dietary supplement industry, issued the

following two-part statement:

Statement by Duffy MacKay, N.D., vice president, scientific and regulatory

affairs, CRN:

" Dietary supplements are used by more than 150 million Americans in combination

with other healthy lifestyle habits such as trying to eat a healthy diet and

exercising regularly. Research consistently shows that dietary supplement users

are higher educated, have higher income levels, and are more likely to engage in

other healthy practices than non-supplement users. This study did not discount

those facts, and expressly noted that supplement users were more likely to be

physically active, more likely to have a lower BMI and waist-to-hip ratio, and

have a lower prevalence of smoking, high blood pressure, and diabetes mellitus.

The authors note in their article that '...dietary supplements are commonly

taken to prevent chronic disease...' The statement would be more accurate with

the addition of one word: dietary supplements are commonly taken to help prevent

chronic disease. In other words, dietary supplements should not be expected, in

and of themselves, and without the synergy of other healthy habits, to prevent

chronic disease.

This study, however, attempts to tease out one piece of the healthy equation for

good health--dietary supplements. CRN maintains that nutrients may be robbed of

their beneficial effects when viewed as if they were pharmaceutical agents, with

scientists looking to isolate those effects, good or bad.

It's important to keep in mind that this is an associative--not a cause and

effect--study. Further, the authors themselves have noted additional

limitations. In fact, when the authors did their initial [minimum adjusted]

analysis, it appears they actually found benefit for many of the supplements,

not just calcium; yet instead of stopping there, they went on to 'further

adjust' the data, possibly until they found statistics worthy of this

publication's acceptance. The study may make for interesting scientific water

cooler discussion, but certainly does not warrant sweeping, overstated concerns

for elderly women.

Further, the authors show their own bias with this statement: 'We recommend that

they [dietary supplements] be used with strong medically-based cause, such as

symptomatic nutrient deficiency...' which basically means these researchers

would rather wait till we all get scurvy before acknowledging any need for

supplemental nutrients.

Our advice to consumers: your best chance for living a long and healthy life is

to engage in healthy lifestyle practices, and many in the scientific community

maintain that rational, reasonable use of vitamins and other supplements is part

of that equation. Talk to your doctor, or other healthcare practitioner, if you

have concerns--but read between the lines of individual studies and don't make

your decisions--either for or against supplements--based solely on hype. "

Statement by Steve Mister, president and CEO, CRN:

" Consumers continue to look for the best way to live long and healthy lives, and

as much as we would like for science to easily give us answers, the fact is that

science is not black and white. But even more concerning is the recent drive to

combine political agendas with what should be pure science. The supplement

industry regularly gets accused of this practice--in some cases rightly so--yet

medical journals seem to be given a pass, as if somehow they held no bias

whatsoever.

Let's look at some of the facts in this publication.

First, within the article itself are a number of opinions including this one:

'Also, cumulative effects of widespread use, together with food fortification,

have raised concern regarding exceeding upper recommended levels...' It's quite

popular these days to talk about overnutrification, but in fact research

consistently shows that most people are falling short in several key nutrients

such as potassium, calcium, vitamin D, and fiber while certain subpopulations

fall short in folate, vitamin B12, and iron.

Second, the authors advise that dietary supplements only be used 'with strong

medically-based cause, such as symptomatic nutrient deficiency...' Given the

high dosages of iron reportedly being used by the women in the study-- iron is

the supplement for which there was the strongest negative association--it is

highly likely the participants were taking the high dosage of iron reported in

the study under a physician's care for an iron deficiency which may itself have

resulted in a shortened lifespan. But the piece purports to warn against

over-the-counter use of vitamins.

Next, the publication invited a commentary from a scientist whose opinion on

supplements and their potential role in good health is already well-known, and

whose own work has been the subject of controversy in scientific circles. In the

spirit of true scientific discourse, wouldn't it have been more appropriate to

invite a commentary from a researcher who might have looked at the data in its

entirety, with sufficient lead time, and provided a different perspective?

The commentary states: '...Therefore, we believe that politicians and regulatory

authorities should wake up to their responsibility to allow only safe products

on the market.' Critics of dietary supplements will continue to advocate that

vitamins and minerals should be regulated like drugs, but even they should

realize that although drugs undergo rigorous RCT testing, many safety issues for

drugs still do exist. Furthermore if nutrients were regulated like drugs, the

cost and availability of supplements would make it difficult for average

consumers to make these products part of their healthy lifestyle.

The editors add their own 'editorial note,' using this study as an opportunity

to bemoan the fact that 'A better investment in health would be eating more

fruits and vegetables, among other activities.' This recommendation comes

despite the fact that we don't see a lot of RCTs for fruits or vegetables

either. Even without RCTs, we agree that people should be eating more fruits and

vegetables; however, in a practical world, consumers are not doing that, and

dietary supplements are an option--not a substitute--for getting some (not all)

of the health benefits from fruits and vegetables.

It's time scientific journals acknowledge they have some biases, just like

industry. "

Note to Editor: The Council for Responsible Nutrition (CRN), founded in 1973, is

a Washington, D.C.-based trade association representing dietary supplement

manufacturers and ingredient suppliers. In addition to complying with a host of

federal and state regulations governing dietary supplements in the areas of

manufacturing, marketing, quality control and safety, our 75+ manufacturer and

supplier members also agree to adhere to additional voluntary guidelines as well

as CRN's Code of Ethics. Visit www.crnusa.org.

(1)ARCH INTERN MED/VOL 171 (NO. 18), OCT 10, 2011

Council for Responsible Nutrition

CONTACT: son, +1-; or Trainor Walsh,+1-

Web site: http://www.crnusa.org/

Copyright PRNewswire-USNewswire 2011