Nov. 29, 2011

MEDIA MAY KILL VITAMNS - Part 1

Submitted as a guest editorial by Suzanne Jenkins, November 20, 2011

What happened to the media that investigates and reports both sides of the story? The practice of denigrating dietary supplements and raising public concern over “safety” has been elevated to an art form by the media. Sound bites and articles with such titles as, “Vitamins May Kill Elderly Americans,” ignore the number of documented deaths caused by prescription drugs. Without both sides of the story, media is playing with half a deck – when this happens in oppressed countries, we call it propaganda.

The current rant over the safety of dietary supplements is really not about safety. Lack of “safety” is being touted as the main reason supplements are under siege. However, ignored by the media is the Adverse Events Reporting System (AERS) of the Food and Drug Administration (FDA), which contains over 4 million adverse events reported from 1969 to the present for FDA approved drugs. From 2000 to 2009, the FDA AERS received 370,056 reports of deaths and 2,345,066 reports of serious patient outcomes from FDA approved drugs, NOT from dietary supplements. Eleven years ago on July 26, 2000, the Journal of the American Medical Association (JAMA) reported that behind heart disease and cancer, ­­­­American medicine was the 3^rd leading cause of death.

The study inspiring the media to create confusion, “Dietary Supplements and Mortality Rate in Older Women: The Iowa Women’s Health Study,” was observational and not the double-blind placebo gold standard with controls on every test component. Doctors and scientists know that an observational study based on a self-reporting questionnaire does not prove cause and effect – but the reader wouldn’t know that from a flamboyant title that indicates sensationalism is more important than substance. Studies like these look for clues that should then lead to further research. They are not designed to be used to guide clinical medicine or public health recommendations.

The value of using dietary supplements to improve the health of the elderly, as well as the health of other sectors of the population, has been confirmed in published studies. The Lewin Group is a health care consulting firm that does policy research and data analysis on Medicare, etc. In their study, “A Study of the Cost Effects of Daily Multivitamins on Older Adults,” the Lewin Group summarized that “given the available evidence, we conclude that daily multivitamins can be beneficial for older adults. Because suboptimal nutrient intake has been linked to chronic disease, the risk from not taking a multivitamin outweighs the minimal risks of taking one.”

Various think tanks have determined that a significant number of older Americans are deficient in vitamins and trace elements and could benefit from taking a multivitamin. A study entitled, “Effect of Selected Dietary Supplements on Health Care Reduction,” commissioned by the Dietary Supplement Education Alliance and updated in 2007, found that taking four specific supplements could reduce health care cost by over $24 billion.

Reviews supporting the use of nutritional supplements have appeared in both JAMA and The New England Journal of Medicine. Some people, due to age, genetic predisposition, environmental insult, lifestyle choices, disability, or disease, have a heightened requirement for dietary supplements.

Media cannot fulfill its obligation to the public when the only source of information considered originates from government, corporations that represent conventional medicine, or sectors that serve both. Media shapes public opinion about dietary supplements with information coming from entities representing only the conventional standard of care model. The Feds, pharmaceutical industry, and media make interesting bedfellows. What we have is mainstream corporate journalism devoted to official positions.

The purpose of thorough and unbiased investigational reporting is to empower the public to deal intelligently with information.  Besides knowing where and when a medical study took place, reporters need to ask critical questions and provide the people they serve with answers to the following:

• Who funded the study?
• What was the original purpose of the study?
• What substances were tested (types and dosages)?
• Did the research involve combinations of nutrients?
• Was the research on isolated components only?
• In the case of hormones, were they synthetic or compounded bio-identical hormones?
• What type of study was it (observational or double-blind placebo)?
• What was the outcome of the study?
• Whose health stands to benefit from the outcome?
• Who stands to profit monetarily from the outcome?
• Were physician/researchers from ACAM (American College for   Advancement in Medicine) or other scientists without financial ties asked to comment on the study?

To connect the dots, the media has to recognize itself as a significant part of the health care problem in the U.S. Since the media shapes public opinion, special interest groups will continue to use the media to discredit dietary supplements and ultimately make them ineffective or unavailable to the public in the over-the-counter manner we enjoy now. Does the media want conventional medicine, with its heavy reliance on expensive physician-dispensed prescription drugs, to be the only game in town? Media must not offer a Trojan horse to a public that relies on it to be impartial and knowledgeable enough to report both sides of the story.

http://www.citizens.org/?p=2810

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PART 2:  Hostile Bedfellows Assail Vitamins

Part 2 of “Media May Kill Vitamins”  – Submitted as a guest editorial by Suzanne Jenkins, November 29, 2011

Over-the-counter dietary supplements are endangered as evidenced by ongoing attacks reported in the media. Currently Senator Dick Durbin and Congressman Henry Waxman are trying a new tactic to discredit dietary supplements after previous legislative failures by asking the Government Accountability Office (GAO) to review adverse event report data for dietary supplements only, excluding the far more dangerous and numerous adverse event reports for drugs and vaccines. Since the media shapes public opinion, individuals and special interest groups that are hostile to dietary supplements will continue to use the media to discredit them and ultimately make them ineffective or unavailable to the public in the over-the-counter manner we enjoy now.

Two thirds of Americans take dietary supplements every day. A significant number of physicians take supplements and recommend at least a multi-  vitamin/mineral combination to their patients. Most supplement takers are well educated and have studied how to use good nutrition and dietary supplements to stay well or improve their health. The skilled choose a healthy lifestyle including a good diet, exercise, stress-reduction and targeted dietary supplements as their first line of defense to maintain and regain health, looking to drugs and the rest of the conventional medical model only when necessary.

Many retiring baby boomers are especially interested in longevity medicine — living healthier and longer by nourishing their brains and bodies in well thought out plans using foods and supplements to prevent or postpone dementia, osteoporosis, heart disease, cancer, diabetes, etc. It is the do-it-yourselfers that bypass conventional medicine’s “standard of care” as much as possible that are a threat to drug companies and government control.

The not-so-well-informed are easily frightened by the attacks on supplements. Many people are unaware of the behind-the-scene shenanigans by politicians and their alphabet agencies such as the FDA — entities that are supposed to protect the public. Adding to the confusion is media failure to provide the public with balanced information. What we have is mainstream corporate journalism devoted to official positions that encourage public fear and corporate greed to dominate the health care landscape.

When one sees an assault on dietary supplements it comes from the conventional arm of medicine – the arm that has established itself as the “standard of care” and the only care that is reimbursed by insurance. Of course, education and discretion in the arena of dietary supplements is necessary. One wouldn’t go into a pharmacy and start taking every drug in sight. The same applies to dietary supplements.  A good multi-vitamin/mineral preparation without iron (look for the GMP seal or its equivalent) is a good place to start while one is learning about the benefits and risks of more sophisticated applications.

When it comes to dietary supplements, a quick way for the public to determine which conflicting medical faction is vying for their allegiance is to look at the rhetoric and source of information. This is important because the media takes all of the health-related information it reports to the public from conventional sources, sources which officially promote that Americans get all of the nutrients they need from a good diet.

The ongoing attack on supplements boils down to money and control issues involving a multifaceted mix of players. In the U.S., the powerful pharmaceutical industry uses its money to influence policy. Politicians need money to fund campaigns for public office. News media, both printed and electronic, accepts advertising dollars from pharmaceutical interests, which makes it easier for media to look the other way instead of reporting on the influence of pharmaceutical dollars as a major source of problems in U.S. health care.

The scenario looks like this:

• Over-the-counter dietary supplements are the primary source of competition for the pharmaceutical industry.
• Americans spend $27 billion on dietary supplements; pharmaceutical interests want to re-route the money to their bottom line.
• In order for the federal government and the medical industry to control health care completely, over-the-counter supplements must be banned or reduced to an ineffective dosage.
• With Medicare spending projected to increase to $900 billion by 2018, the Feds are looking for ways to trim cost and dietary supplements are on the Feds’ radar screen as a cost-cutting measure, thus providing more incentive for pharmaceutical interests to gain control of supplements.
• DSHEA (Dietary Supplement Health and Education Act of 1994) presents a problem for conventional medicine. DSHEA gives Americans the right to purchase safe, over-the-counter supplements in useful dosages.
• The FDA is currently attempting to undermine and re-write DSHEA by re-defining the terms regulating dietary supplements in its new Draft Guidance.  NDI (new dietary ingredients) is a side door which provides an indirect way to decimate the dietary supplement industry by increasing the cost to manufacturers in the name of providing a higher degree of “safety” for products appearing on the market after 1994, resulting in increased seizure of products and driving smaller companies out of business.  The newer products which could disappear include supplements such as the Ubiquinol form of CoQ10, Resveratrol, Grape Seed Extract, Pycnogenol,  Alpha Lipoic Acid, N-Acetyl-Cysteine, Green Tea Extract, etc. Details may be found in the FDA’s “Draft Guidance for Industry: Dietary Supplements: New Dietary Ingredients: Notifications and Related Issues.”
• On the international front, the U.S. signed the World Health Organization’s trade agreement, Codex Alimentarius, which may supersede the laws of the countries signing it. Countries not in compliance are considered holdouts and may not be allowed to trade. Codex has the potential to override our DSHEA if the FDA doesn’t undercut it first.
• When pharmaceutical interests control the supplement industry, conventional medicine will control health care options.

A take-over of dietary supplements by conventional medicine will destroy the self-care/wellness care industry, reduce the quality of life for many, and result in premature death for people who depend on supplements to survive. This is especially true  where conventional treatments have failed but individuals have found a restorative combination of options beyond standard of care.

In the U.S., conventional medicine’s “standard of care” for health care is based on detecting disease, NOT on preventing it. Conventional doctors are trained to focus on symptoms, identifying and naming the disease, trying to match the drug to the name, and if drugs alone fail, then combinations of surgery, radiation, and drugs may be employed.

In conventional medicine, if there is no insurance code for a health issue, insurance will not pay. Insurance covers very little, other than prescription drugs, surgery and/or radiation, for a recognized health problem. Conventional medicine is a closed system wherein billions of pharmaceutical dollars influence doctors, osteopaths, pharmacists, hospitals, nurses, dietitians, nursing home facilities, insurance companies, research institutions, med school curriculum,  physicians continuing education, Medicare, government regulatory agencies such as the FDA, professional associations such as the AMA, National Cancer Institute, American Heart Association, etc., and politicians who set up the system and allow it to operate in the current manner.

Dietitians also want part of the action. In the state of Texas, registered dietitians (RD’s) petitioned the courts to recognize RD’s as the only legal source for dispensing nutritional information. So far, RD’s have lost their bid for exclusivity but the turf war is also flourishing in the field of nutrition. Fortunately, dietitians are beginning to question the influence of junk food purveyors and the results of overuse and abuse of pharmaceuticals experienced by their clients. You will know dietitians are making progress when foods in hospitals, nursing homes, and public schools are nutritious, delicious, and build health rather than destroy it. Up until recently, dietitians told the public there is no such thing as a bad food, only bad diets.

Quackwatch, an American non-profit organization, has the stated aim of combating health-related frauds, myths, fads, fallacies, and misconduct, according to Wikipedia. Most alternative treatments, including commonly used dietary supplements, are considered quackery on this site. Google “CanLyme, Quackwatch Founder Loses Major Defamation Trial in Hometown” and “Quackwatch Review” by Dr. Ray Sahelian, M.D.

An entrenched medical model built around disease is more profitable for those in control of the system, but it only represents half the deck. Limiting options places a strangle-hold on treatment plans available to the patient, especially in a hospital setting where malnutrition and acquisition of hard-to-treat super bugs like MRSA and C-Diff are common.

Conventional medicine is at its best in acute illness or trauma but doesn’t work well in treating complex, chronic disease because its primary focus is not on understanding the drivers causing the disease and working with reframing how the biology works, using raw materials that build health and removing impediments to good health. However, there are doctors who are becoming more open to modalities outside conventional medicine’s “standard of care” but it may take many years for a discovery to be accepted into clinical practice. People who are seriously ill do not have many years to wait for their physician’s enlightenment or for the system to reinvent itself.

The best health care option is called functional medicine, a patient-centered, science-based health care approach that integrates the best of both traditional Western and alternative or integrative medical practices. Functional and conventional medicine use the same concept of science but the difference is in the details and the application. Functional medicine involves understanding the origins, prevention, and treatment of complex, chronic disease using the continuum concept. There is a continuum from optimal health to hidden imbalance to serious dysfunction to disease. Intervention and reversal of the process can occur anywhere along that continuum, but the sooner it is addressed, the better.

Functional medicine creates a focus on prevention through nutrition, diet, and exercise; use of the latest laboratory testing and other diagnostic techniques; and prescribed combinations of drugs and/or botanical medicines, supplements, therapeutic diets, detoxification programs, or stress-management techniques. In the case of inflammation, conventional medicine would suppress it and functional medicine would focus on finding out why inflammation is happening in the first place and change the trigger causing the problem. For example, if an individual has a problem with gluten, a gluten-free diet would be used.

Practitioners of functional medicine look “upstream” to consider the complex web of interactions in the patient’s history, physiology, and lifestyle that can lead to illness. The unique genetic makeup of each patient is considered, along with both internal and external factors.

Functional medicine is a whole-system medicine; a GPS system that connects the the patient to the whole story of medical science by looking for and addressing upstream causes of downstream disease processes before they become debilitating or life threatening. Combining everything that works increases the likelihood of optimal patient outcomes at a lower cost to the system and the individual.

No American wants to be without conventional medicine’s crisis intervention in acute, life threatening situations but it shouldn’t be the only choice for chronic health problems that are managed best by an integrative approach.

The media needs to question conventional medicine’s obsession with the risk of taking supplements rather than with the value supplements provide to the knowledgeable consumer. Today, 50,000 Americans have no insurance to pay for U.S. health care, which is the most expensive and fragmented health care in the world. People need access to diverse, not restricted, health care options.

High tech medicine is only about 100 years old. Compare that to other cultures which have thousands of years of historical controls involving the use of diet, plants, and herbs to ameliorate health problems. Conventional U.S. “standard of care” health care is not the repository of all wisdom. For the media to allow itself to be used in the scheme to eventually deny the public access to safe and affordable supplements is a blow to wellness care and freedom of choice.

http://www.citizens.org/?p=2870