
Nutrition: Vitamins on trial  - sizzle
http://www.nature.com/news/nutrition-vitamins-on-trial-1.15459
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amirmc
Aside: I found the following visualisation fun and somewhat interesting (on
supplements and the ailments they might be good for). It's changed a lot over
the years and it links off to the underlying spreadsheet.

[http://www.informationisbeautiful.net/visualizations/snake-o...](http://www.informationisbeautiful.net/visualizations/snake-
oil-supplements/)

~~~
raverbashing
This is a nice graph (but does the X axis have a meaning?)

But the important thing there is that they're measuring their role as a
supplement, however, most of them are needed (and present in a healthy diet),
while some aren't

Potassium is a needed element of a diet, and as the article mentioned, there
seems to be a lot of deficiency, but maybe a better understanding of
deficiency/needed dose is needed.

~~~
amirmc
Scroll down the page and you'll see a description.

 _" This image is a “balloon race”. The higher a bubble, the greater the
evidence for its effectiveness. But the supplements are only effective for the
conditions listed inside the bubble.

You might also see multiple bubbles for certain supps. These is because some
supps affect a range of conditions, but the evidence quality varies from
condition to condition. For example, there’s strong evidence that Green Tea is
good for cholesterol levels. But evidence for its anti-cancer effects is
conflicting. In these cases, we give a supp another bubble."_

edit: Apologies, I misread your comment. The X-axis can be modified on the
interactive version to sort by: alphabetically, popularity or scientific
interest. The static version is alphabetical. Beyond that, it's just to help
spread things out to be readable.

~~~
raverbashing
I'm asking about the position of the bubble on the X axis (maybe it doesn't
mean anything), I know about size and Y axis position.

~~~
hyperion-
Alphabetic order.

~~~
raverbashing
Yeah, looks like it

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gregwebs
This article is a good example of the arrogance around nutrition. A third
possibility is that we don't know enough to be able to manufacture vitamins in
a factory.

When one eats un-manufactured food

* for a given nutrient there are many different forms of it

* there are many inter-related nutrients that effect each other (nutrient synergy)

Take a look at how many forms of Vitamin A there are on the Wikipedia entry.
The idea that we can pick one and load up on it may not be correct. This is
true of many minerals also because they need to be bound with something else
(magnesium malate, etc).

The odd thing about nutrient synergy is that it is very well established
scientific phenomenon. But it just doesn't fit well with our reductionist
approach to science.

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digitalengineer
I work for the FMCG (Fast moving consumer goods) and can tell you vitamins do
one thing very well: help sell stuff. (Vitamin c is easily added to just about
anything to make it 'more healthy' looking. I think vitamin c is probably the
most abused added vitamine...

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ekianjo
There's a bunch of Cosmetic companies using Vitamin E in their products too.
With slightly more evidence that it does something... if I remember correctly.

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RBerenguel
Not counting what vitamin E may do to skin (it supposedly helps it), it keeps
other oils from going rancid. So, it's a kind of a preservation measure.

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nazgulnarsil
Our current causal models of how nutrients behave in our bodies are woefully
incomplete. Many of the substances referred to under the term "Vitamin X" come
in many forms that do different things. It is unsurprising that an isolated
compound doesn't help much. MealSquares address exactly this issue. We know
we're supposed to eat a variety of whole foods but we don't. So we put a whole
bunch of nutrient dense foods in a convenient package. Bioavailability is much
much better than supplements.

~~~
vanderZwan
There's also the fact that the absorbtion of a nutrient can depend on what
other nutrients are being digested at the same time. For example, adding iron
to breakfast cereals is _completely_ ridiculous.

First of all, it's added as pure iron. _You don 't absorb iron in its mineral
form_, it needs to be in some organic form to be digested. So that already
makes it totally pointless.

But let's ignore that for a moment and pretend we could digest mineral iron.
Turns out that if your food contains iron and calcium, the calcium will take
precedence and effectively block the absorption of iron. And what do we pour
on our breakfast cereals? Oh, right. Milk.

It also can work the other way around: vitamin C helps with the absorption of
iron.

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jmhain
It shouldn't matter whether something is a drug, vitamin, or dietary
supplement. What matters is whether there is scientific proof of efficacy for
what you are trying to accomplish.

I have long struggled with social anxiety, and under stressful situations
severe panic attacks. I found out via examine.com (fantastic website for
getting scientific info on supplements) that inositol (vitamin b8) is
potentially more potent than SSRIs in treating anxiety disorders. I bought a
tub of the stuff and sure enough there has been a dramatic dose-dependent
reduction in symptoms.

Unfortunately, because it's "just a vitamin" there is limited data available,
so I have no idea how safe it is or whether it has any long-term effects.

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jbb555
I wish there were small supplements that contained maybe 10-20% of the
recommended amounts of things. I eat reasonably well. Most of the time. So I
probably get enough of most of the vitamins and minerals. But I'm sure some I
get more than others so a _small_ boost might help overall.

But I don't want to take one of the multivitimins that has 100% of everything
in, that just ensures that I have way too much of some things.

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amirmc
> _"... that just ensures that I have way too much of some things."_

That only matters if the body cannot quickly flush or discard the things it
doesn't need. It's probably different for each type of supplement. As a
supporting example, it would be quite difficult to drink too much water as
there's an easy mechanism to deal with it [1].

[1] Before anyone leaps on that statement, yes, I'm aware that it _is_
possible to overdose on water.
[http://en.wikipedia.org/wiki/Water_intoxication](http://en.wikipedia.org/wiki/Water_intoxication)

~~~
gus_massa
Vitamin A and D are more problematic because they are fat-soluble and the
excess can’t be flushed away in pee. Other vitamins, like vitamin C, are
water-soluble so a little excess is not so bad, but IANAMD.
[http://www.medicinenet.com/script/main/art.asp?articlekey=10...](http://www.medicinenet.com/script/main/art.asp?articlekey=10736)

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bcbrown
My thinking on vitamins is governed by several principles:

The data is inconclusive

As a recreational and occasionally-competitive athlete in powerlifting, my
vitamin requirements are likely abnormal, especially during intensive training

Medical studies usually focus on mortality, whereas I'm also interested in
athletic potential and quality of life

I take a multivitamin and sometimes macro-dose on C and E.

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loxs
And no D?

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bcbrown
I take D in the wintertime.

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sambe
I'm not sure I completely understand the criticism of the negative results.
All of the supposed biases seem to apply equally to the control group (more
healthy to start with, different baseline intake, not completing the course of
pills) and to other studies in different areas.

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Nursie
The supplements industry is basically snake-oil so far as I can tell. Unless
you have a known deficiency, or a horrifically unbalanced diet, as far as
anyone can tell they're a waste of time and money.

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vanderZwan
So basically... vitamin D and probably not much else.

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Nursie
If you have a known deficiency, sure, but a quick web search will show you
that it's arguable what level is deficient, and that it's arguable that
supplementation has a good effect on anyone that's not suffering from a few
specific conditions.

So I'll repeat - unless you have a known deficiency or a restricted diet,
they're a waste of time and money, and the industry is snake-oil.

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BSousa
While I agree, at least for Vit. D, the issue is what is considered
'deficiency' is quite low by doctors/blood tests. I don't remember the values,
but even doctors that a few years ago laughed (yes, laughed) on my wife and
mine face because we we concerned about it and the effects of low Vit. D in
her pregnancy are now recommending to their patients some supplementation even
for known normal levels. (One doctor told us the only concern for low Vit. D
levels were for the +65 year olds for example)

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icelancer
It is also dependent on your profession and location. If you are a collegiate
or professional athlete living in the Northern US where sunlight exposure is
generally bad for 6 months out of the year, then while your Vit D levels may
just be below-average (but nothing major for a normal human), this could be a
real issue regarding athletic performance.

Supplementation and testing must always be taken in context. The average
sedentary human does not have the same caloric needs as the aspiring
professional athlete, nor do they have similar supplementation needs either.

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BSousa
I fully agree. Athletes, pregnancy, high-stress jobs, depression, etc. Each
have different concerns and specific nutrition focusing on them can be quite
efficient at mitigating symptoms/improving results. Also location as you
mentioned and genetics as well can influence the requirements of certain
nutrients.

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Quequau
years ago, probably also in nature, I read that the only certain thing that
the studies found about vitamins was that it made for expensive urine.

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digitalengineer
It's even worse: For decennia it was thought too much vitamin C would exit
your body easily by urinating. Instead it's rather harmful:
[http://www.nytimes.com/1998/04/09/us/taking-too-much-
vitamin...](http://www.nytimes.com/1998/04/09/us/taking-too-much-vitamin-c-
can-be-dangerous-study-finds.html)

