Sunday, May 1, 2011

#34 Nutrition Fatigue

“There was an article in the paper that women who take calcium are more likely to get heart attacks,” my loyal assistant, Tania reported to me one morning. “Should I stop taking my calcium?” she asks ominously.

“E Tu, Tania, E Tu?” I lament dramatically.

“As usual, I have no idea what you are talking about,” she snapped, uncharacteristically irritable.

I hate to say it but Tania has been a tad bit cranky lately. Her mood seemed to shift slightly last month after a freak accident and subsequent major surgery to insert a foot long titanium rod into her leg. The only good thing that seemed to come out of this horrible ordeal is that after years of failed badgering on my part, she finally started taking her supplements regularly. Now it seemed even this small benefit was in danger of being lost under the constant onslaught of negative media reports on supplements.

There is a condition called, compassion fatigue that happens to people when they are so overwhelmed by hearing horrible stories of suffering that they just cannot feel anymore. A general numbness descends. The news media has managed to create this in most of us regarding every major disaster in the last few decades with relentless, non-stop reporting of every tragic, pain ridden moment.

A similar condition happens with “health” reports regarding nutrition which I call nutrition fatigue. Much of the information is negative. Some of the more recent sound bites (insert ten exclamation points to mimic intensity of reporting) claim fish oil does not lower cholesterol, choline causes heart disease, calcium does not protect the bones and melatonin causes precocious puberty, scratch that, now it delays puberty.

No wonder everyone is confused, scared or discouraged because nothing works and the world is going to pot anyway. The solution is to take a deep breath, check into the situation more thoroughly by reading the actual research and think it through. Who has time for all that? Exactly.

I do take the time to do this because people tend to stop taking their supplements in response to these irresponsible reports and I get a lot of panic laced questions. There are so many reported health news disaster stories to pick from but let’s start with calcium because I have already gotten several questions about the study Tania mentioned. Calcium use to be an uncomplicated nutrient until sound bite reporting got to it.

You may recall the beginning of the made-up calcium debate. It involved the huge Women’s Health Initiative study published in the New England Journal of Medicine a number of years ago. The initial headlines screamed that taking calcium does not help bones!!!!!! The comprehensive study had over 36,000 women in it and the ones taking calcium did not have any less fractures than the other group, the reports trilled. Women all over the country viewed their calcium supplements with suspicion. My phone started ringing.

Upon careful review of the study, it turned out that half the women in the calcium supplement group did not actual take their calcium. They were naughty. Unfortunately, there were so many naughty women that removing their data from the study would have invalidated it, so the researcher left the non-compliant ladies in. Garbage science. The study really proved that if you do not take your supplements, they do not work. No big news item there.

In this case as the study was scrutinized, new amended reports started to surface. One from ABC News asked the question, “Does calcium help bones?” Then it answered that in a big study (the same one), women who took calcium had significantly less breaks but they had to take calcium for a long time. So, it was not a quick fix and by the way, maybe it increases kidney stone risk. I guess just saying, “yeah, it does”, would have been boring because everyone already knew that anyway.

The study Tania heard about was a new unexciting study about bone health published in the British Medical Journal. To spice it up, the results were reported with the byline, “Calcium builds bones but may weaken the heart. “ However, there was insufficient evidence in the study to prove or refute an association between taking calcium and heart disease. The researchers were not even looking for a calcium and heart disease link but after the study was done were picking through the data to see what else they could put together to report.

People taking calcium before the study started had no increase in cardiovascular incidents but in the group given calcium for their study there might have been slightly more heart incidents but the association was murky because of many other variables. No problem. Maybe someone else had found an association they could apply, after the fact, to their study. They looked through the literature for other studies to boost the possibility and start a debate.

Researchers from the Women’s Health Initiative (WHI) study weighed in that they did not find any increased cardiovascular risk in the 36,000 women in their study. The new investigators had to be looking very hard to come up with this vague association, one WHI researcher pointed out. (Of course, it is hard to say if one can trust the WHI based on what their researchers initially reported about their study.) There may be science here somewhere but it sounds more like a reality TV script for The Real Biology PhDs of Cambridge. This kind of “I wonder if”,” chitchat should be limited to conversation between researchers over a few beers on a Friday afternoon and not reported as science news.

The result of this sensationalized reporting is some people worried about heart disease, stopped taking their calcium. A larger number of people already forgot the details of the latest report but are building a sense that nutrition is confusing or there is always something wrong with supplements. While annoying and destructive, the results are mild compared to what happens when the financial stakes go up. Then the marketing people get involved and start spinning the results to be sure you take away what they want you to believe which can be very distant from the real findings.

To be continued….

1 comment:

  1. Hi Kelly,

    What blood test for foods do you recommend? Is there one that tests several foods, that is reliable?