Sunday, April 28, 2013

Be Nice To Your Bacteria and They May Return the Favor

Bacteria are everywhere; it is estimated that 100 trillion bacteria occupy our guts composed of 500 to 1,000 different strains. Yet, what most people know about bacteria is its relationship to illness. Who hasn't over the course of their lives been prescribed an antibiotic for one bacterial infection or another?

So bacteria are bad, right? Not always. Some people know that there are such things as good bacteria, referred to as probiotics. (For more on probiotics see my blogs, More On Probiotics at and What About Probiotics? These 'healthy bacteria' are believed to live in our gut in a symbiotic relationship--we feed them and they perform some helpful functions for us.  But, some of the bacteria in our gut are dangerous and only pose a problem when they grow out of proportion of their usually small numbers. They are called opportunistic bacteria because they take advantage of opportunities to multiply when the normal state of affairs is altered. For example, although antibiotics kill certain harmful bacteria, they also destroy some helpful bacteria. This shifts the balance for control of the gut and allows some harmful bacteria to overgrow due to the decrease of the healthy bacteria that usually keep them at bay.

The results of a healthy balance of gut bacteria has been long known.  It keeps the gut working properly and in many cases means normal bowel function. Some people think that by taking probiotics they are maintaining a healthy gut. Unfortunately, the science doesn't support that simply taking some probiotic, whether composed of a single strain of bacteria or a blend, whether containing hundreds of millions or even billions of colonies, really makes a difference in the face of the complexities and interactions among the 10 trillion various bacteria. The situation is simply far too complex for such a simple solution.

It's not that putting bacteria in the gut can't help.  Recent studies support that putting fresh feces from a healthy family member down a naso-gastric tube (a tube inserted through the nose that reaches the stomach) is actually the most effective treatment for a Clostridia Difficile (C. Diff) infection, which is a bacterial infection that often develops in response to someone taking too many or for too long, antibiotics.  This bacterial infection created by antibiotics often proves resistant to even more antibiotics taken to restore normalcy.  However, the healthy bacteria found in the fresh feces are able to overcome this 'bad' bacteria and restore the gut.  The idea may be unpleasant to you, but it works.

Recently, some new discoveries regarding the bacteria in our gut have been made. It's been long known that meat eaters have different bacteria in their gut then vegetarians, but the significance wasn't known.  It was recently shown that these bacteria are associated with increased risk of heart disease due to productive of a compound called TMAO. The studies show a relation to carnitine and lecithin in your diet. I won't bore you with the science other than to say that TMAO levels were found to be highest in those routinely consuming meat and eggs.  Another interesting study done in mice (human relevance unknown) showed that in obese mice who undergo gastric bypass surgery, the composition of their gut bacteria changes, probably as a result of change in diet. This has also been shown to be true in humans.  In the mice experiments, researchers took the new bacterial composition of strains from these no longer obese mice and injected them into obese mice. Guess what happened? The obese mice lost weight without surgery.

It's been debated for some time if the bacteria in an obese person are a result of the obesity or a causative factor. This mice study suggests it is causative and you can bet that some resourceful scientists are now researching if using the gut bacteria from patients post gastric surgery that have slimmed down or even bacteria from normally slim people can be used as an effective weight loss tool.  It is an exciting avenue of study and I am sure it will produce some exciting results in the not too distant future.

In the interim, limit your meat and egg consumption to one piece of beef no more often than once every two weeks and to no more than two egg yolks per week. Eliminating both altogether if you can isn't a bad idea either. In their place, get your healthy protein from wild fish like salmon and once a week chicken.  Your bacteria may not thank you, but it doesn't mean they are not grateful.

Monday, April 22, 2013

Everyone Needs Calcium. Where Should You Get It?

On February 15, I wrote a blog titled Calcium and Heart Disease: What's the Story? Here is the link if you want to review it.

That blog highlighted the possible dangers of taking calcium supplements and added that "the bottom line is everyone needs calcium and it is best and safest to get it from foods like broccoli, almonds, tofu, sardines, kale and other leafy vegetables, and almond milk. As I am not a fan of dairy, I don't recommend dairy products but Greek yogurt, etc. are also good sources of calcium."

I didn't spend  a lot of time in that blog discussing one of the other potential dangers of taking calcium supplements, which is the development of the most common type of kidney stone made from calcium oxalate. 

To mostly quote and sometimes paraphrase an article that appeared in MedlinePlus, here's the latest understanding of the role of calcium in kidney stones.

Scientists knew that getting lots of calcium from foods lowers the likelihood of kidney stones in those most at risk, but thought that it may only be true for calcium in milk.  Well a new study makes clear the benefit isn't just linked to milk products.

So first the good news. In a large new analysis, men and women who consumed the most dietary calcium from foods had about 20 percent lower risk of developing kidney stones than those who consumed the least calcium. The key takeaway is unlike calcium in pill form, don't avoid calcium in food as it is good for you.

"This is another piece of data to suggest that there's no role for dietary calcium restriction for kidney stones," said lead study author Dr. Eric Taylor, a kidney specialist at Maine Medical Center in Portland.  As stated earlier, most stones that form in the kidneys are made of calcium oxalate and past studies have found that eating calcium-rich foods - though not taking calcium supplements - seems to ward off stone formation."

Since most people typically got their calcium primarily from dairy products, "there was lingering doubt about whether some other component of milk might be responsible for the effect." To address this question, Taylor and his colleagues set out to see whether the results held true for calcium from non-dairy foods. To do so, they "analyzed data from three large studies that followed more than one million men and women, sometimes for decades, and included periodic detailed food questionnaires.
The researchers divided those participants into five smaller groups, based on how much calcium they consumed from dairy and other sources over as long as 20 years.

Only participants who were generally healthy and had never suffered from a kidney stone before dietary data collection began were included."

More good news. "For both dairy and non-dairy sources of calcium, people who consumed the most calcium were least likely to develop painful, symptomatic kidney stones - overall, their risk was 77 percent of that seen among people who ate the least calcium, Taylor's team reports in the Journal of Urology....

For non-dairy foods, people who consumed 250 milligrams of calcium a day - the amount in eight ounces of cooked kale or two sardines, for example - were twice as likely to develop a stone as people who got 450 milligrams daily.

Rates of kidney stones in the U.S. translate to the average person having a 6 percent chance of developing a stone during a lifetime. So, in the new study, low calcium consumption doubled that risk to 12 percent."

But here's the kicker. "Because most kidney stones are made of calcium oxalate, it might seem counter-intuitive to consume more calcium and end up with less in your kidneys, but there is theory about why it works...The real culprit is oxalate, not calcium. Oxalate is found in many foods including fruits, vegetables, nuts and chocolate, and calcium binds to it avidly. The more calcium in the digestive tract, she said, the more oxalate it can bind and take out of the body before the oxalate is absorbed into the bloodstream and ends up in the kidneys and bile duct.

Here's the bad news. Many patients don't understand this relationship and cut back on calcium anyway, which actually increases their risk, according to Dr. Mathew Sorensen, a urologist at the University of Washington in Seattle.
"I see patients every week, and most have cut back on their calcium intake," Sorensen told Reuters Health in an email. "It is one of the most important myths in the stones world that needs to be corrected."
Really excessive calcium levels aren't a good idea either, Sorensen said. He recommends patients keep levels moderate, around 1000 to 1200 milligrams per day."

So let's summarize.
1. You need calcium in your diet as it is one of the 15 essential minerals.
2. Dietary calcium binds oxalate in your intestinal tract to reduce oxalate's absorption into your blood stream, which reduces your risk for developing calcium oxalate kidney stones.
3. If you can avoid kidney stones and the sudden and very painful problems they cause, you should absolutely try to do so.
4. It is best to get your calcium from food in reasonable amounts as it is considered safe to get your calcium from dietary sources.
5. While milk and other dairy products are known sources of calcium, there are healthier alternatives such as almond milk, (Silk Brand, Unsweetened, is recommended) to get adequate calcium.
6. Calcium supplements remain a potentially dangerous source of calcium, whether or not taken with magnesium.

If you know of a doctor who continues to recommend calcium supplement pills, please ask him or her to review their information because it is out of date. Maybe you can even educate them. For me, an educated patient is my favorite type.

Sunday, April 14, 2013

A Primer on Being Rich and Healthy

In the iconoclastic film, A Fiddler On the Roof, Tevye, the main character, a poor farmer, sings a song titled, If I Were A Rich Man. Some of the stanzas are notable for what they say about Tevye's perception of what it means to be rich.

Foremost, he sings that if he were rich, he "wouldn't have to work hard." Prized among his possessions would be "chicks and turkeys and geese and ducks." These fowls would signify wealth to the other townspeople. Finally, in describing what the wife of a rich man would look like, he says "about his wife, Golde, looking like a rich man's wife, With a proper double-chin. Supervising meals to her heart's delight."

Simply put, to Tevye, being rich means being fat, lounging around, and eating a lot. My, how things have changed.

According to the British Telegraph, a leading London newspaper, "Over the last century – for the first time in history – an odd phenomenon has emerged in developed societies: the richer you are, the more likely you are to be thin. Wallis Simpson nailed the phenomenon several generations ago, when she said, "You can never be too rich or too thin."

George Orwell noticed a related phenomenon in 1937, in The Road to Wigan Pier:

"The ordinary human being would sooner starve than live on brown bread and raw carrots. And the peculiar evil is this, that the less money you have, the less inclined you feel to spend it on wholesome food. A millionaire may enjoy breakfasting off orange juice and Ryvita biscuits; an unemployed man doesn't… When you are unemployed, which is to say when you are underfed, harassed, bored, and miserable, you don't want to eat dull, wholesome food. You want something a little bit 'tasty'. There is always some cheaply pleasant thing to tempt you. Let's have three pennorth of chips! Run out and buy us a two-penny ice-cream!"

But the British are not the only ones experiencing this sea of change, As Americans struggle with an obesity epidemic and related illnesses often referred to as "diseases of affluence" such as heart disease, diabetes, and cancer, a paradox has emerged. Today, it appears that it is the truly more affluent who seem to have a better handle on the effects that food has on one's health and are in the position to make better lifestyle choices. Buying organic fresh produce and wild salmon imported from Alaska, balancing work-life demands, taking time to stay physically fit or indulging in a personal trainer or even a gym in your own home seem to be only the domain of the wealthy.

Unlike in ancient times when wealthy landowners and monarchs like Henry the Eighth could satisfy their every gastronomical craving by feasting on the beasts of the land and in turn, develop their characteristic double chins and pompous bellies consistent with their coveted status, the smart money now sees the world differently. Living a healthy lifestyle now seems to cost more, not less. Those with money or those who value health are taking the smart steps to live longer and healthier lives.

It would seem like a disturbing paradox, if it were true, but it's not. The truth is that most anyone can make the choice to avoid fast food and sweets, stay physically fit, work on friendships, etc. Money helps, but it's not the end to end all. Okay, so if you don't have the budget for organic, you will have to eat conventional fruits and vegetables over the pricier stuff. That's not a big deal because they are both equally nutritious. There are always farmer markets and farming cooperatives about that offer fresh produce at affordable prices. Walk whenever you can. Do jumping jacks and sprints if you can't afford a gym membership. Don't believe everything you think is a fact. It's not. Smile more. When people ask you how you are doing, answer absolutely fantastic. Believe it.

Yes, it may be easier to do all these things when you are rich, but don't be fooled for a second that money offers any guarantees. There are still plenty of overweight wealthy people whose money has failed to increase their intelligence or decrease their illnesses. These people, who are none the smarter for their fatter wallets, continue to ignore the daily warnings and consume what they please with reckless disregard to consequences.

So the question for you is simple: Which would you prefer? To be a rich person who can afford to live a healthier lifestyle but chooses not to or a not so rich person who has the smarts to do so? It's not that you can't have both money and smarts, but just recognize what's more important. You see money can't buy you health (doctors don't make you healthy) any more than it can buy you happiness. Whether you have lots of money or not, the most priceless asset will always be your health.

Therefore, please indulge me as I rewrite a few of Tevye's stanzas to reflect how a rich man should really be:

"If I were a rich man,

Ya ha deedle deedle, bubba bubba deedle deedle dum.

All day long I'd biddy biddy bum.

If I were a wealthy man.

I wouldn't have to stop being physically active

Ya ha deedle deedle, bubba bubba deedle deedle dum.

If I were a biddy biddy rich,

Yidle-diddle-didle-didle man.

I'd fill my yard with organic kale, nuts, berries, and avocados

For the town to see and smell.

And each aroma would delight the senses

As if to say "This is what it means to stop and smell the roses like a wealthy man."

If I were a rich man,

Ya ha deedle deedle, bubba bubba deedle deedle dum.

All day long I'd biddy biddy bum.

If I were a wealthy man.

I wouldn't have to stop being physically active.

Ya ha deedle deedle, bubba bubba deedle deedle dum.

If I were a biddy biddy rich,

Yidle-diddle-didle-didle man.

I see my wife, my Golde, looking like a rich man's wife

With a slender figure, positive demeanor, and looking well slept.

Distributing meals to the homeless to her heart's delight.

I see her helping others and bringing joy to those around her.

Oy, what a happy mood she's in.

Laughing with and smiling at people, day and night.

If I were a rich man,

Ya ha deedle deedle, bubba bubba deedle deedle dum.

All day long I'd biddy biddy bum.

If I were a wealthy man.

I wouldn't have to stop being physically active.

Ya ha deedle deedle, bubba bubba deedle deedle dum.

If I were a biddy biddy rich,

Yidle-diddle-didle-didle man.

As far as I'm concerned, the greatest wealth is our health. If you don't believe me, just ask someone with failing health what they would give up to restore their health. Their answer will be priceless.


Monday, April 8, 2013

When Is A Medical Study Reliable? It's Getting Harder To Tell.

Whether you are new to my blog or a faithful reader, you should know of one of my favorite made-up Latin sayings, which is Caveat Lector, “Let the reader beware.” You may think my railing against the written word  conveys a certain level of paranoia about the attempts of others to mislead us by giving inaccurate and misleading reports. If so, the old rephrase, “just because you are paranoid, doesn't mean they are not out to get you,” comes to mind.

So it is bittersweet to share an article that appears in today's New York Times, titled Scientific Articles Accepted (Personal Checks, Too). I say bittersweet because it is sweet that I can offer confirmation of the need for one to be circumspect when reviewing scientific studies, and even more diligent when reading stories prefaced on such studies. On the other hand, it is bitter because of the invasion of baseless Journals offering worthless studies that can only further exacerbate the degree of confusion of the average person as to what advice to follow and which to ignore.

The Times article states in reference to scientists being duped into presenting at a conference that feigned legitimacy, “Those scientists had stumbled into a parallel world of pseudo-academia, complete with prestigiously titled conferences and journals that sponsor them. Many of the journals and meetings have names that are nearly identical to those of established, well-known publications and events. 

Steven Goodman, a dean and professor of medicine at Stanford and the editor of the journal Clinical Trials, which has its own imitators, called this phenomenon “the dark side of open access,” the movement to make scholarly publications freely available. 

The number of these journals and conferences has exploded in recent years as scientific publishing has shifted from a traditional business model for professional societies and organizations built almost entirely on subscription revenues to open access, which relies on authors or their backers to pay for the publication of papers online, where anyone can read them.

Open access got its start about a decade ago and quickly won widespread acclaim with the advent of well-regarded, peer-reviewed journals like those published by the Public Library of Science, known as PLoS. Such articles were listed in databases like PubMed, which is maintained by the National Library of Medicine, and selected for their quality.

But some researchers are now raising the alarm about what they see as the proliferation of online journals that will print seemingly anything for a fee [bold added for emphasis]. They warn that non-experts doing online research will have trouble distinguishing credible research from junk [bold added for emphasis]. “Most people don’t know the journal universe,” Dr. Goodman said. “They will not know from a journal’s title if it is for real or not.”

One ambitious soul has taken to creating a list of dubious journals. According to the Times, "Jeffrey Beall, a research librarian at the University of Colorado in Denver, has developed his own blacklist of what he calls “predatory open-access journals.” There were 20 publishers on his list in 2010, and now there are more than 300. He estimates that there are as many as 4,000 predatory journals today, at least 25 percent of the total number of open-access journals.”

Folks, it is getting tough out there for credentialed scientists and legitimate doctors to know which Journals to trust. I can only imagine the pain for those less educated. The proliferation of misinformation is growing, creating a crisis of confidence regarding reliable scientific studies, even for the more savvy among us.

One of the readers of my blog, named Helen, likes to respond every so often to something I wrote.  She will often share what she believes to be "facts.” She is undoubtedly an avid reader because she will commonly refer to one source of information or another.  Try as I may to convince her that the facts she offers are often inaccurate, that her sources may be questionable, and therefore her information, unreliable, she insists that she is right and our disagreement is merely a difference of opinion.  I hope the story in the Times sounds a cautionary alarm for Helen that just because someone publishes something somewhere, it doesn't mean it is reliable. 

For the rest of my readers, I promise that I will try to stick to the facts. I say that with the caveat that it is getting harder to know what the facts are when misinformation seems to be dropping like bombs during a blitzkrieg.  So Helen if you are reading this, stop pretending that you know "the facts” because you read them somewhere on the internet. To paraphrase Mark Twain, “don't take advice from a health website, you could die from a misprint.”

Wednesday, April 3, 2013

Is Dr. Oz Reliable? You Decide

On Dr. Oz's show today, Oz sounded an alarm about the misuse of anti-depressants by primary care doctors for treating their patients' depression and the off-label use for other psychological illnesses, such as anxiety and insomnia.  He explicitly made the statement that no patient should be prescribed an anti-depressant by anyone other than a psychiatrist. He made that point emphatically. (By the way, I actually agree with him on this one  However, because I find that psychiatrists are often quick to prescribe, I prefer to send a patient first to a psychologist for a proper evaluation.)

To quote his own blog, "On today’s show, we’re addressing the growing problem of the over-prescription of antidepressants in our health-care system. In order to treat common medical conditions, many physicians have resorted to unnecessarily prescribing medications to patients who don’t need them. We’ve already seen this issue with pain medications and antibiotics. Not only does it cost a lot of money, it carries risks as well."

Oz goes on to write in regards to the fact that most anti-depressant prescriptions are written without a psychiatric diagnosis that, "This can lead to dangerous results. Recently published research suggests that antidepressants may make one more prone to depression later in life. They also may increase your risk of suicide. In 2004, the FDA required a label on antidepressants, warning of the risk of increased suicidal thinking and behavior among children and adolescents who take antidepressants.

He adds, "There’s also research that suggests that antidepressants may not even work at all. Most antidepressants work by increasing levels of serotonin in the brain. However, there’s very little evidence that shows that depression is caused by a serotonin imbalance alone. Usually, there are other psychosocial or medical factors that play a factor in someone’s depression."

So to be clear, Oz is saying that raising serotonin levels in the brain may have nothing to do with treating depression as there is scarce evidence, according to him, to support that conclusion.

So why is Oz a hypocrite you may ask? I'll let you be the judge.

Two weeks ago, the Dr. Oz show featured a trio of practitioners, two MDs, and one naturopath declaring the great value of using a compound called 5-HTP to treat depression among other disorders.  5-HTP is an over the counter, virtually unregulated dietary supplement that has had no major clinical trials to support its effective, safe, and long-term use in depression. In fact, a number of organizations warn against its use for any indication, such as weight loss.

I can't make this stuff up. Here's Oz's own website material.

A Q&A posted on his website.

Can 5-HTP be used to treat depression? 5-HTP is typically used to treat mild depression based on the theory that as a precursor to serotonin, a neurotransmitter that has a calming effect, these supplements can increase serotonin levels and influence mood, sleep patterns and pain control. 5-HTP effectively increases the central nervous system (CNS) synthesis of serotonin. Serotonin levels have been implicated in depression, anxiety, pain sensation, and sleep regulation.   

Here's a quote from his blog.

"5-HTP is a chemical compound that is naturally produced in your body as it makes serotonin, an important hormone for regulating your mood...In addition to suppressing your appetite, there is some research that suggests that 5-HTP can also help treating headaches, insomnia, depression... [bold added for emphasis]." end of quote. 

So let's make sure we all got Oz right. If a primary care physician who knows a patient well prescribes an anti-depressant for his or her patient, that's bad because the patient hasn't been evaluated by a psychiatrist. But it's okay for Dr. Oz and a couple of doctors on his show to tell a national TV audience of patients they know nothing about, including any medical history whatsoever, that it's proper to use 5-HTP to treat depression because it apparently increases serotonin, the brain hormone.  Wow!  

When it comes to supplements that may screw with your brain, he doesn't flinch in telling you to take them even when the science is iffy. But when it comes to other doctors, particularly primary care doctors and internists, prescribing approved medications he doesn't hesitate to throw them under the bus.  

If that's not inconsistency, then I don't know what is. What do you think?

Tuesday, April 2, 2013

When It Comes to Supplements, You Haven't Seen Anything Yet!

When it comes to supplement marketing, it's about to get really scary. Hold your wallets and purses close to you. Let skepticism be your friend and close companion.  Know that you've been warned.

"Like a lot of aging Americans, consumer products and drug companies are hoping vitamins will give them an energy boost," so begins the article that appeared in the Monday April 1, 2013 article in the Wall Street Journal titled With Top Lines Dropping, Firms Reach for Vitamins.

The article continues with, "Procter and Gamble Co... drug maker Pfizer Inc. and Arm & Hammer...owner Church & Dwight Co. all acquired makers of dietary supplements last year. More deals are expected, as companies bet baby boomers and rising health-care costs will drive demand for products that promise health in a bottle."

But here's the kicker from the article, "Supplements appeal because they can tap into the desire for health remedies and claim high prices, without the hassle of tough U.S. regulatory oversight."  Got it? These companies know they can make a pretty penny from an unassuming populace without much fear of regulatory oversight. In fact, here's what the WSJ article says about that. "Unlike prescription drugs, vitamins, minerals, botanicals and other dietary supplements don't need to be approved by the Food and Drug Administration as safe and effective in order to be sold; that means the products don't have to undergo clinical testing in humans that can take years and cost hundreds of millions of dollars." In other words, these companies pursuing huge profits from supplements don't have to rely on science to make their case--just on marketing.

What does that mean to you the consumer? It means that you will be further inundated by mostly worthless in your face products as the WSJ writes, "Some major retailers are allocating more shelf space to health supplements, giving manufacturers the room to move more brands and products. The sector is shaping up to be a battleground between pharmaceutical players and consumer-products companies, many of which are trying to counter slow growth in their mainstay businesses."  It's a war, and when retail wars break out, more product moves, just it did during the Cola Wars between Coke and Pepsi, a period which saw soda consumption skyrocket and obesity become an epidemic.

According to the WSJ, " Laurent Faracci, chief strategy and marketing officer of Reckitt Benckiser USA, said the company can get its newly acquired brands like Airborne and MegaRed supplements into more drugstores and mass-retail channels where it already sells products like Lysol disinfectants and Mucinex decongestants. The company also plans to work with key retailers to better present the vitamins and supplement brands in stores."

So it isn't bad enough that nearly 50% of Americans already use multivitamins of little utility (really big studies in men and women involving tens of thousands of people, including physicians and nurses, say so) and as many as 80% use some other form of supplement, often self-prescribed for who knows what use. Now, we have the really big consumer product companies like Proctor and Gamble getting into the mix to push supplement sales to the next level.

Okay, you say. I get it. These products are not what they are held out to be. But why do you rail against them as much as you do? Here are my eight answers to that question.

1. Supplements are basically unregulated products other than for requiring so called "purity," which means virtually any compound, unless a known poison and even if it has never been scientifically vetted for safety, can be put in the bottle as long as it says so on the label.

2. They are not free and people spend their hard-earned money on products that usually offer no measurable benefit or particular pleasure.  Remember, none of the world's centenarian communities historically used any pill-form synthetic supplements since the first supplements were not even manufactured and marketed until the 1930s.

3. They give people a false sense of security that all they need to do to stay healthy is to take these pills.

4. They create a licensing effect which means people think they can engage in unhealthy behaviors such as overeating or eating unhealthy foods because the supplements will protect them.

See video about John Cloud's experiment with 3,000 supplements:,32068,1141008036001_2091643,00.html

Case in point: The step-father of a close friend of mine joined us for dinner one night. He had just completed shopping for his daily supplements and had spent over $1,500 on a variety of pills. At the dinner, he proceeded to order and eat a hamburger on white bun with french fries.  I bit my lip watching this fiasco in the making.  No amount of supplements, or healthy food for that matter, will protect one from the harms of french fries and fried hamburger meat.

5. Supplements are marketed on the false pretense that you can't get virtually all their known benefits from natural foods, exercise, meditation, and sun. Many of their claims are based on the myth that most fruits and vegetables are grown in nutrient depleted soil. This is untrue as nutritionally depleted soil would prohibit the normal growth of produce. So by definition, if it grows, it has enough nutrients.  I confirmed this by review of over one hundred such studies that validated this fact in 100% of cases.

6. While the companies themselves cannot make preposterous claims about the usefulness of their products, others, such as Dr. Oz, can.  The spokespeople for these supplement marketers often claim no direct benefit from advocating on behalf of these products, but the advertising of these companies that pay for their shows, websites, and magazines would suggest indirect benefit at a minimum.

7. Supplements represent at their best nutritional isolationism. What this means is that one can isolate out certain essential nutrients and that is all one needs to be healthy. For example, such logic would support the argument that there is no difference between vitamin C in an orange and synthetic vitamin C. Chemically, they look the same but the synthetic one deflects light in two directions, while the natural C reflects to the left. More importantly, the natural vitamin C is surrounded by enzymes, co-enzymes, activators, precursors, antioxidants, and other synergistic nutrients all found naturally in the fruit. The synthetic vitamin C is either offered alone or in combination with other synthetic, isolated vitamins. Which would you prefer? Which do you think is better for your body? It is foolish to focus on isolated nutrients in the absence of a particular deficiency when nature has always packed a powerful punch by combining all kinds of good things together from time immemorial. No nutritional researchers have even begun to scratch the surface of what synergism among all 700 nutrients in a strawberry actually means or the 300 in an apple.  Given the choice between nature and factory, between what nature offers us and supplement marketers peddle, I say choose the fruit and vegetable.

8. For those new to my blog, the bottom line is Caveat Lector, 'Let the reader beware."  There is so much misinformation available through blogs (including possibly mine), websites, TV shows, magazines, newsletters, etc. that you can't just read something as gospel and assume it is true. Verification with a resource that doesn't stand to gain from your decision is your safest bet.  Contrary to some misinformed pundits, doctors don't benefit from prescribing medications and are therefore not in the pockets of Big Pharma as some claim. If supplements worked, many physicians would willingly prescribe them for their patients. Besides, contrary to the conspiracy theorists, many of the supplement companies are owned by Big Pharma, like Pfizer which owns Centrum, and that little fact alone should help one discard such theories.

9. Finally, the biggest danger that supplements pose is the false security that people develop about self-diagnosing and self-medicating as some supplements actually do have medicinal-like effects. So, please don't self-diagnose and even more importantly, please don't self-prescribe simply because some very clever and capable marketers can pull on your heart strings and create fables of perpetual good health and disease prevention based on myths of taking some pill or another that hasn't ever been shown in a valid human study to have value or effectiveness, at least not for the reason you are taking it.

It's about to get intense out there in retail-land. Big, huge, deep pockets trying to make money off of you buying supplements, throwing every marketing ploy and trick at you from their highly refined book of strategies. They made a mess out of our eating habits leading us down the path to obesity and increased heart disease. (If you don't believe me, read the book by Pulitzer Prize winner Michael Moss called Salt, Sugar and Fat.)

So put on your blinders and put in your earplugs lest you fall victim to their cunning images and deceptive siren songs. The Supplement War is on. G-d help us all.