The Value of Vitamins

It all started with the important discovery of vitamin deficiency diseases like scurvy, pellagra and rickets and now it's become a huge industry. You can hardly venture onto public transport without seeing adverts for supplements on railway stations, in tube trains or on the backs of buses. Anyone would think vitamins and minerals were to the body what oil is to the engine of a car - a simple top up and smooth running is assured.

It's very hard for the average consumer to make informed decisions in this area - the products sound tempting and "everyone's" taking them, so they must be good, mustn't they?

Doctors tend to be conservative on the subject - "you only need vitamins if you have a vitamin deficiency disease" would be their traditional position statement.

"Nutritionists" are far more liberal. They believe that vitamins not only prevent diseases but can also "heal" all manner of ills. They recommend a vitamin (or six) for every ailment. As if that extra oil in the car could mend a broken engine part. They tend to be overly eager to support their beliefs by citing  evidence from experiments involving cells and mice.

In the middle ground we have the lucrative supplement industry with a vested interest in convincing us that we need supplements and so getting us to part with our money.

So what's the scientific take on all this?

Evidence cannot convince the scientific community unless it involves a large group of humans (not genetically modified mice), taking vitamins over a long period of time, with a "blind" comparison group taking placebos. Only then can you check whether the supplements are safe and whether any positive effects result. Such trials are, of course, very expensive and are consequently rather rare. Such studies that do exist have sometimes shown no benefit, or even demonstrated harm to those who take vitamin supplements for long periods.

In summary - the better quality evidence has generally been "disappointing" inasmuch as it has failed to show that supplements reduce your chances of avoiding colds or cancers, or that they increase your chances of living longer. Vitamins cure vitamin deficiency diseases, but evidence that they are curative in other areas is very flimsy indeed.

The other problem for consumers is that vitamins are very lightly regulated. In Europe, now, you cannot even hint on packaging that a food has an active health benefit. There are only a few examples that are approved by the European Food Standards Agency (notably oats and the cholesterol-lowering products such as Benecol margarine). Food packaging is still allowed to bear words like "fortified with Vitamin A" or "a source of vitamin C" as long as they contain minimum amounts of the relevant nutrient.

Where food supplements are concerned, as long as they are not actually toxic or contaminated and as long as they make their claims in qualified terms such as "may help support a healthy immune system" they are very lightly regulated. In other words there is not a lot of consumer protection.

Cochrane systematic reviews are a good place to look if you want to check the best evidence about supplements. A new book has been published which goes into more myth-busting detail and it looks like interesting reading.

http://www.thecochranelibrary.com/view/0/index.html

http://www.guardian.co.uk/lifeandstyle/2013/jun/07/vitamins-stop-taking-the-pills?INTCMP=SRCH

Healthwash

When I was a child my grandmother sometimes felt the urge to whitewash. A bucket of lime and water was mixed and a clean, chemical odour filled the back yard. No finesse was needed, just a rough and ready paintbrush and a strong arm. She would disappear into the outside toilet and attack its walls. Grime, dust, fly-dirt, cobwebs and unwary spiders were swiftly smothered in a pristine, gritty layer. Then she would look around to see where the remains in the bucket could be deployed. Round the outside drains, on the walls near the bins, anywhere else? I could tell she found it satisfying to turn dingy areas hygienically white, without the fuss of proper decorating.

Whitewash covered a multitude of sins and it has come to mean anything that deliberately conceals mistakes or faults.

Much more recently the word “greenwash” was coined.  If you haven’t come across this term, it means: disinformation disseminated by an organization so as to present an environmentally responsible public image. An extreme example might be an oil company boasting about their track record on recycling while planning to despoil vast tracts of Alaskan wilderness.

One of the aims of this blog is to bring you examples of "healthwash", which I'm defining as disinformation included in marketing, advertising and packaging, so as to present a healthy image.

There's a lot of it about in the aisles of the supermarket. You know the sort of thing. A product claims to contain a substance that has a healthy reputation, or to be “free from” something that has an unhealthy reputation. Thus the brand is health-washed. The aim is, of course, to convince busy shoppers that they are making a healthy choice. There is an armada of buzzwords and phrases that bombard us again and again – vitamins, minerals, five-a-day, antioxidants, fibre, grains, fruit, unsaturated, free-from, low in, part-of-a-healthy-diet and so on. Despite a recent tightening of the rules on health claims on food packaging there is still wide use of these many of these terms.

Then there’s the fuzzier stuff :- natural, all-natural, pure, country, home-cooked, hand-cooked, wholesome, herbal and so on - all of them suggesting an association with health.

Lets face it, eating a healthy diet consists of consuming moderate quantities of uncomplicated foods, preferably prepared at home, from fresh ingredients. When you are eating healthily you can usually see exactly what you’re eating. Most of the complications occur with manufactured foods that contain a long list of ingredients.

When you buy something in a packet, a jar or a tin there is a lot of small print  (often very small indeed) about nutrition. This information is not easy to understand. The terminology varies (Vitamin C or ascorbic acid? Salt or sodium?) and it changes over time. No sooner do you understood the idea that saturated fats are bad and un-saturates good, than you have to get you head around the various Omegas and their relative merits.

Then you have to mentally juggle the amount of nutrients per 100gms, the amounts of nutrient per serving, and the percentage of your recommended daily consumption that this amount represents. And then there is calculation of how the recommended serving size compares to the amount in the packet. You need an A* grade in your GCSE Maths to stand a chance of working out the relative health benefits of a product. Degrees in chemistry and statistics would also come in quite handy.

If you studied all the labels while filling your supermarket trolley, you would be there for hours. You’d need a magnifying glass to read the labels and a calculator to work out the maths.

So it's inevitable that most of us look at the headlines - those enticing words, designed to suggest that we are buying something reasonably healthy. Words that are carefully chosen to cast a veil over less unhealthy aspects of the product and create, instead, a shiny, healthy glow. Watch out for future blogs that will highlight the truth behind the healthwash and help you to become a more sceptical shopper.