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JAMA publishes innocuous supplement study but still finds space for criticism

A new study finds supplement usage stable between 1999 and 2012. But critics still have something to say.

The legend goes that famed literary wit Dorothy Parker once said, “If you don't have anything nice to say about someone, come sit next to me.” In the natural products world, the saying goes that, “If you can’t say something nice about supplements, you’re probably Pieter Cohen." Or the Journal of the American Medical Association.

It’s almost like clockwork—news breaks about supplements, and Cohen, an assistant professor of medicine at Harvard Medical School, pops out to call them dangerous, or at least worthless.

That clockwork was in action Wednesday when the journal released a study finding that supplement usage was spot-on stable between 1999, when 52 percent of the 38,000 interviewees reported using supplements, and 2012 when—wait for it—52 percent reported using supplements. It wasn’t especially shocking news. It was barely even news. But any news is an opportunity for Cohen to speak out, and JAMA provided the soap box.

The journal gave him space for an editorial and Cohen, as the clockwork demands, trotted out to cite studies finding no benefit and to raise the alarm about dangerous ingredients. He brings up ephedra and calls out 10,000 calls to poison control centers in 2002, failing to note, of course, that ephedra is an example of the system working. An ingredient was found to be dangerous and it was removed from commerce.

He does allow that supplements are helpful for nutrient deficiencies (though he fails to mention how shockingly widespread such deficiencies are) and states that “a specific combination of vitamins and minerals” can slow age-related macular degeneration. But he decries “significant leeway” in structure function for keeping sales high against all the criticisms. Cohen argues that doctors need to be telling their patients about the negative studies and advising them “there is no benefit of obtaining vitamins from a pill rather than from conventional food.”

Of course, doctors should be talking to their patients about nutrition, and the Council For Responsible Nutrition emphasized that in their press statement response to Cohen’s piece. Doctors talking to their patients about nutrition doesn’t happen nearly enough. That would indeed be helpful.

Cohen’s broad brush broken record is not so helpful, and it’s puzzling that JAMA allowed him the space to go with such an innocuous story. That antagonistic stance isn’t helpful at all.



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