February 28, 2007 The Pump Handle 10Comment

By David Michaels

This is how it always works. A leading medical journal publishes a study saying a commercial product may be dangerous, perhaps even killing people. The trade association representing the manufacturers quickly attacks the study (preferably in the same news cycle), accusing the scientists of incompetence or worse.

The latest issue of the Journal of The American Medical Association (JAMA) includes a study that links that use of antioxidants (beta carotene, vitamin A, and vitamin E) with increased mortality. The issue was published today. Yesterday, the Council for Responsible Nutrition, the diet supplement industry’s trade association, issued a scathing press release, calling the study “muddled” and based on an “unsound scientific approach.”

The press release worked. The press coverage of the JAMA article included the trade association’s disparaging comments. The Washington Post quotes the Council for Responsible Nutrition’s Andrew Shao: “The message to the average consumer is: Don’t pay attention to this. This doesn’t apply to you.”

What the trade association is doing here is what I’ve called manufacturing uncertainty. The associations say scientists don’t agree, so there is no reason to limit intake of what may be dangerous amounts of drugs. It’s a public relations trick used most widely by the tobacco industry, but also by many, many polluters and producers of dangerous chemicals.

The JAMA paper examined the results of 68 randomized trials of dietary supplements, involving 232,000 participants. The authors found that, in the trials with strongest methods (47 trials involving 180,938 subjects), antioxidants were associated with significantly increased mortality risk. This is consistent with the evidence to date. There have been several clinical trials that found antioxidants, especially beta-carotene, increased lung cancer risk; there is little human evidence that they reduce cancer risk. The JAMA paper is a systematic compilation and synthesis of data from previously published papers.

The fact that these chemicals don’t prevent cancer has not stopped the diet supplement industry from promoting them widely. The ill-conceived Dietary Supplement Health and Education Act (DSHEA) of 1994 deregulated the marketing of dietary and herbal supplements, much to the detriment of the public’s health.

The press deserves some criticism here, too. The debate over the existence of global warming seems to be over, but until recently virtually every newspaper article describing a scientific paper on the issue included commentary by one of the handful of oil industry supported scientists who insisted the science just wasn’t there.

As long as the press continues to give equal time to both sides of the debate – in this case independent scientists on one side and self-interested producers of potentially dangerous, unregulated chemicals on the other – we can expect to see a confused public and uncontrolled hazardous exposures.

David Michaels heads the Project on Scientific Knowledge and Public Policy (SKAPP) and is Professor and Associate Chairman in the Department of Environmental and Occupational Health, the George Washington University School of Public Health and Health Services.

10 thoughts on “Do Antioxidants Cause Cancer or Prevent it? The Diet Supplement Industry Manufactures Uncertainty

  1. I’m in favour of keeping the “fairness” in media. But I want labels:

    For example, when I’m watching TV news I want a large red label indicating:

    “This is not gathered news created by a genuine reporter. It’s a VNR (video news release) shot by a PR company. Any information you see here requires several grains of salt before use in a decision-making process. But what can you do, head office says we have to fill 22 minutes and cut our staff and budget again, so we’re dependent on this.”

    “This opinion has been found totally divergent from any facts.” (Use for White House press stagings).

    In the case of Fox I expect to see “Lies Lies Lies” flashing in a continual band across the screen. It’ll save time and electrons.

    With newspapers, I want source citations, just as one would get for academic information: “#3 The quote: ‘I hope all the Christian babies get set on fire by hippies’ is attributed to Al Gore in the Limbaugh Letter, February 30, 1977.”

    Maybe a sort of rating system? Like there is for the movies?

  2. One of my teachers thought a great job would be a Epi guru (M.D. or not) who could respond to the newest health news with a spinner or temperature gauge behind them. They could give a quick summary and then turn to their gauge and say “This research ranks above coffee talk for soccer moms, but below ever mentioning to anyone else” or some such sillyness. The top of the gauge could be reserved for “freak out and call your doctor immediately” and the bottom “call your congressman and complain about why this was funded”.

    I’m sure like all things it would get perverted to the dollar or personal agenda, but at least it would be better than hearing another story about how they found the gene that causes farts or some other such sillyness.

    Also, I give a nod to Dr. Shao and the diet supplement industry association for their own pseudo-type 3 error[sic]. JAMA does a phenomenal job of packaging their results with canned video interview and ‘what does this mean’ synopsis so the MSM will air their articles, for a fee of course. JAMA, imo, does deserve some noise for claiming that the 95% interval in 180,000 participants is above 1.0. No shit. Gimme a 180,000 participants and I’ll show you a significant relationship between booger picking and all-cause mortality. No, they don’t need noise for pointing out the obvious, but then again, is the noise from Dr. Shao et al. really going to stop the message from getting to his customers? No, they aren’t going to listen anyways.

  3. This misinformation campaign was brilliantly successful. I read the New Scientist news article (in the print edition) and thought the claim that “the trials included people who were already sick” meant they weren’t double blind, and therefore the report was useless. In fact all the studies used for the report’s conclusions were well blinded, so the supplement manufacturers claim is deceptive. In fact many sick people start taking supplements – eg vitamin A or carrot juice on being diagosed with breast cancer – so including the effects on their health is relevant.


  4. I have to say I don’t expect the supplement industry to behave any differently.

    But surely the question we should be asking is why this made the media at all. The only story of public interest here is that if anti-oxidants have an effect it’s too small to make out clearly. Perhaps specialists might take away more, but I can’t see a better way to gloss the results for wider consumption.

    I’m seriously annoyed by the way the media picks up on the publication of individual papers as news stories. Maybe you can’t blame news editors. But that’s not how science works. Scientists should know better than to allow press releases to be put out with papers.

    I would still think that for an earth shattering paper, let alone one like this that honestly belongs in the Jounal of Negative Results.

  5. There are secret meeting going around in America about drafting Al gore. WAit a moment . Al Gore was involved in the DIetary Supplment Act of 1994, He may nt like Hiliary Clinton but they both knew about it and supported i t and Clinton even pardon an ex con who was in the dietary supplment business. so if Al GOre runs he is going to be hit with a fastball and the Gop will bash it to him daily. WE like you al but you sold us out

  6. That is interesting. I still think it would be important to choose a variety of fruits and vegetables high on the ORAC scale of antioxidants, and make them a regular part of your diet.

  7. cant really rely on such studies huh? Im just wondering why people from years ago and lived in non technological civilization seldom get cancer.

  8. I guess the researcher’s needed the “anti-oxidants will kill you”-line since the decades of “we can’t find any protective effect of anti-oxidant supplements”-lines didn’t really get any notice. There was even a paper this spring in PNAS that anti-oxidants attenuate the adaptive response to exercise.

    Eating vegetables and fruit will protect your health! Some people thought it was because of the anti-oxidant content but subsequent scientific inquiry has shown that it is not so! Communicating this is going to be so damn hard!


    PS Metro, I love your idea!

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