science Wednesday, March 3, 2010 . This is a SciScoop post by David Bradley
Some dietary supplements, nutraceuticals, vitamins and antioxidants are proving their efficacy in clinical trials and research for specific conditions, others are unadulterated snake oil. Information is Beautiful posted a pretty, but relatively unscientific, animated bubble chart to show where each supplement might sit in the sphere of health for a given condition. Needless to say, I shared the page on Twitter and Facebook and see that it’s had well over 4500 visits.
The site claims the chart is a representation of the scientific evidence for supplement efficacy for healthy adults on a good diet, apparently. Bubbles that float to the top are apparently those with more PubMed and Cochrane citations for a given supplement-condition. Bigger bubbles, means more Google hits.

A clinical friend pointed out that folic acid is shown as having only “good” evidence; whereas it is a standard prescribable medication. Folic acid/folate is standard first-line pregnancy advice and on FP10 prescription and has been for a long time to combat neural tube defects. One would have assumed that this would have been based on ‘strong’ rather than just ‘good’ evidence.
Of course, good to strong evidence is pretty much all prescription medications get. There is no proof in science.
Bruce Head also pointed out some other problems with the bubbles. “I find the chart interesting but confusing. Some supplements are showing up equally in the ‘strong evidence’ area and BELOW the ‘worth it’ line – for the same condition. For example, check ‘Cancer’ and ‘All types’ and ‘Selenium’ appears in both areas. Similar with ‘Mental Health’ and ‘Omega 3′,” he says.
It’s also worth noting that there are seemingly no magic supplements for sex, despite those ads in the back of the magazines and in your spambox. Glucosamine shows up as conflicting evidence for pain, whereas a whole range of supplements like acai, silica, taurine, wheat grass, dandelion, cranberry etc have no evidential links either way (pro or con) to any conditions. Green tea is below the worth it line for cancer in general and close to the bottom (no evidence) for breast and prostate cancer, and weight loss. Similarly, not a lot of proof that probiotics protect against colon cancer and no good evidence for black cohosh in menopause. It’s a mixed picture.
I suspect the bubble chart is not quite as scientific as it might seem, especially if it’s based on a loose PubMed and Cochrane citation count and Google hits, rather than a conventional meta analysis of the data. I would always suggest taking anything like this with a pinch of salt…although salt should of course be above and below the line for cardiovascular and dehydration cramps, so not too much now.
Previously: « Periodic papers
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2 Responses to Scientific evidence for supplements and snake oil
David Brown
March 3rd, 2010 at 9:47 pm
Omega-3 appears to be the supplement of the decade. The therapeutic benefits of omega-3 fish oils have been getting a lot of attention. What’s not being noised about is the fact that even better benefit can be achieved by reducing omega-6 consumption to safe levels. I can vouch for the benefit of reduced omega-6. I 1993 I developed a skin ulcer after bumping my shin on a saw horse. Three months later after trying every remedy proffered by physicians, relatives, and friends I took a few days off work to alternately soak my leg in Epsom salts and elevate. I also used the time to read a book by Canadian physician and pioneer vitamin E researcher Wilfred Shute entitled Vitamin E: Health Preserver.
I’d always been skeptical of E because the nutrition textbooks of that era asserted that it was impossible to develop a deficiency. Dr. Shute claimed he used vitamin E to successfully treat diabetic gangrene, phlebitis, congestive heart failure, and skin ulcers. So I obtained some, applied it to the wound, and swallowed the recommended dosage. Improvement was dramatic. The pain subsided and the hole filled in with granulated tissue just as described in the book. Eventually, I figured out that I had trashed my immune system by consuming too much omega-6 mayonnaise and salad oil. By eliminating those foods from my diet I thought I had solved the problem.
About 8 years later I began to lose strength and flexability in my legs. The pain made it difficult to get out of a chair and eventually I lost the ability to run. I kept exercising but hiking down hill was difficult. Then, last November (2009) I heard Dr. Bill Lands say this: “…there are some really interesting foods that have more omega-3 than omega-6; but not all. Did you know that peanuts have 4,000 milligrams per 28 gram, one ounce serving of peanuts? 4,000 milligrams of omega-6 and one milligram of omega-3. The United States is the land of peanut butter. Grow our kids. Make our kids healthy. Whoops.”
Whoops indeed! I’ve been eating a sandwich for lunch 5 to 6 times a week since my discharge from the military back in 1972. When I learned how much omega-6 was in peanuts I switched to meat and cheese sandwiches. That was about three months ago. Recently, I noticed an increase in muscle strength in my legs. In addition, the pain associated with stretching has subsided. I am able to run again, jump, get up from the floor, and stand up from a chair without thinking about it.
After realizing my mistake I began researching omega-6 trying to figure out why there’s so little mention of the hazards associated with excessive consumption. I read through five years of Consumer Reports on health finding lots of comments regarding the therapeutic benefits of omega-3s but no mention of omega-6s. Hopefully this will change now that the saturated fat is bad myth is being scrutinized [1].
Arguably, excessive omega-6 consumption has been the worst public health disaster of the 20th century and beyond [2]. The financial cost in terms of lost productivity is incalculable. Then, there’s the pain, suffering, and security issues. Just one small example: A June 2006 AJCN article entitled “Healthy intakes of n–3 and n–6 fatty acids: estimations considering worldwide diversity” concludes: “To our knowledge, inadequate information is available to determine whether it is safe or unsafe to consume 9% of all calories as LA (omega-6), a precursor to the proinflammatory arachidonic acid. One ecologic study indicated that greater intakes of LA from 1960 to 1999 in each of 5 countries predicted a 100-fold greater risk of homicide mortality. The increases in world LA consumption over the past century may be considered a very large uncontrolled experiment that may have contributed to increased societal burdens of aggression, depression, and cardiovascular mortality [3]. Conversely, actively lowering LA intake must be carefully considered because of the large potential effects on agricultural economies.
Now, that’s really sad. Farmers are producing all these subsidized, energy intensive, ecosystem-destroying seed oil crops that furnish raw materials to food manufacturers to make foods that ruin our mental and physical health and these scientists are concerned about disrupting the flow of commerce in order to make people healthy? Well, it’s good to be cautious. The thing is, with reasonable certainty, scientists now know how hazardous omega-6 truly is. But little is being done to fix the problem.
1. http://www.washingtonpost.com/wp-dyn/content/article/2010/03/02/AR2010030202091.html
2. http://trusted.md/blog/vreni_gurd/2010/02/28/how_good_are_you_at_choosing_healthier_fats
[3] http://thepaleodiet.com/articles/Dietary%20Fat%20Quality%20%20CHD%20August%202009.pdf
Anthony
March 9th, 2010 at 4:31 pm
Interesting post. And nice reply from David Brown. I am a bodybuilder, and I started supplementing with an omega 3 supplement that has a high ratio of EPA and DHA. In addition, I started using flax seed oil as my number one source of fat.
To make a long story short… I played baseball my entire life. I was a catcher, so you can imagine the pounding my knees took. Every time I would squat, my knees would become inflamed until I woke up the next morning. After I started taking my omega 3 supplements, flax seed oil, and cut back on my consumption of omega 6′s… my knees are now pain free as well as the rest of my joints. Not only that, my recovery time between workouts has been cut down by at least 24 hours. Might not sound like much but in bodybuilding that’s a huge improvement.