Media wars: how science news traps supplements

Anyone reading newspaper headlines lately would wonder how the top-selling dietary supplements could be glucosamine, chondroitin and calcium, and the herbs saw palmetto, echinacea and St John's wort.

After all, according to the mainstream US media, none of these six — with combined sales close to $2 billion annually — works for their heralded benefits.

Unless you read the trade press.

The recent glucosamine/chondroitin study for osteoarthritis is a sterling example. The headline in The New York Times read, "Supplements fail to stop arthritis pain, study says." Square that with a press release headline from the Council for Responsible Nutrition: "Study shows supplements relieve osteoarthritis pain."

So, which is it?

Overall, the study found no real difference between benefits in any of the treatment cohorts in the mild-pain group — 60 per cent for placebo, 64 per cent glucosamine alone, 65 per cent chondroitin, 67 per cent a combination of the two, and 70 per cent the pharmaceutical drug Celebrex (celecoxib).

However, there was a subgroup of 22 per cent of subjects with moderate-to-severe arthritis pain who experienced a significant 79 per cent benefit when taking the two supplements together, compared with 69 per cent for Celebrex and 54 per cent of the placebo group.

Daniel O Clegg, MD, the study's principal author, noted in The New England Journal of Medicine that these patients with severe pain "demonstrated that combination [supplement] therapy significantly decreased knee pain related to osteoarthritis."

This apparent inability of the media to get into study details is enough to rankle many an industry member
This apparent inability of the media to get into study details is enough to rankle many an industry member. Clearly, the industry views study results from a glass-half-full perspective. But the reason these supplements are top sellers is the consumer belief that they work, due in no small part to years of studies validating their bioactivity. So, does a single well-publicized negative study (even if it's not entirely negative) invalidate the amassed body of research?

"It's up to us to urge the research community to not look at science as one brick at a time but a series of bricks that build a structure," said Judy Blatman, vice-president of communications at the Council for Responsible Nutrition. "What you're not seeing is the bulk of the media coverage putting stories into context. One reason is the researchers and often the publications are competing for either research dollars or for readership. So they are positioning their study as the 'be-all and end-all' study in conclusion."

When government-funded research studies do not confirm earlier research but forge new ground, it becomes tricky. And while the industry welcomes new research applications for old ingredients, when these well-funded, well-publicized studies return negative results, they seem to discard all we used to know.

All the recent studies tend to fall into this category. A study on saw palmetto for prostate enlargement, published in the February 2006 New England Journal of Medicine, did not confirm the herb's documented benefits on mild to moderate prostate enlargement but concluded its null effects on severe, late-stage prostate enlargement. Regardless of this significant detail, the headline in The Wall Street Journal read, "Popular herb shows no benefit for prostate."

Another recent example of unfair supplement bashing came from the February New England Journal of Medicine report that, according to the New York Times headline, "Big study finds no clear benefit of calcium pills."

It was not until the tenth paragraph in the Times article that the key study detail was unveiled: When researchers looked only at those who actually complied with the study parameters and took their supplements at least four out of five days for the seven-year study — the supplements reduced hip fractures by a significant 29 per cent. In a separate subgroup of women over age 60, those taking the supplements saw a 21 per cent reduction in hip fractures.

But even this apparently good news for the calcium trade was immediately tempered in the Times article, explaining such results were "simply by chance."

What's the industry to do?

"This is not the media vs the dietary supplements industry," Blatman said. "This is the constraints of what the media has to do. The people who write headlines have a whole different set of issues, like space and deadlines. Yes, we're concerned in the way the scientific and research community seems so quick to close the door on supplements. We have to continue to work with government agencies, with researchers, with the media, with educating consumers that science is an evolutionary process. Another brick in the wall."

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