Don’t Take Your Vitamins | Hacker News Reader

Don’t Take Your Vitamins

nytimes.com

175 pointsColinWright172 comments

First of all, the author sells a book about vitamins being bad, so he's probably not being objective about it.

I'm also biased in favor of taking daily supplements, because I take daily supplements and don't want to feel like a fool. That said, here's some analysis of his sources:

Most of the articles he (doesn't) link to are about harmful effects of beta-carotene and vitamin A, which coincidentally turn out to be mostly the same thing, just in a different form. Checking out the one article I found [1], they gave 30mg of beta-carotene (16K UI), and 25000 UI of retinyl palmitate, which converts to a total of 41000UI of vitamin-A, or 800% of the recommended daily dosage.

That dosage is insanely high. I have a very good "mega multi" vitamin, and it only contains 200% of vitamin-A, because it is well known that vitamin A and vitamin D are one of the few vitamins that are actually harmful at large doses, and you can get poisoned/die from overdoses. It's the reason why you don't want to eat polar bear livers. To OD on vitamin A is quite easy, with effects being seen starting at daily 21000 UI doses. So no multivitamin pills actually contain that high of an amount of vitamin A. I find it strange that he's not talking about specific brands, probably because none of them contain the high amounts that are used in the articles he talks about.

It doesn't surprise me that taking 41000 UI has adverse effects, since it's known that this is already well over OD limits, and is especially risky for smokers, who have a lower OD limit.

All in all, the reasons he puts forward why mega doses are bad, are not relevant to consumer vitamin pills because the doses are not in the same ballpark. I would also like to see the amount of lives saved because of the pills - much like airbags and car belts, there might be people who die from using them especially, but there might be many more people saved as well, turning it into a net profit.

[1]: http://www.ncbi.nlm.nih.gov/pubmed/15572756

I agree entirely. Also, instead of giving proper references to papers, the author takes the scumbag approach of being vague "in 2004, a review of 14 randomized trials for the Cochrane Database found that the supplemental vitamins A, C, E and beta carotene, and a mineral, selenium, taken to prevent intestinal cancers, actually increased mortality."

That, alone, should qualify this article as tripe.

This is an article in the NY Times, not a scientific paper. Providing all those direct references would not make for good reading. The Cochrane Library is a very reliable resource, and I think it's valid to assume that the author is not simply making this up.

> This is an article in the NY Times, not a scientific paper.

This is the attitude that I'm trying to address.

> This is an article in the NY Times, not a scientific paper.

Look at this discussion on HN. How many of them give references. Is their writing any less clear for it?

> The Cochrane Library is a very reliable resource, and I think it's valid to assume that the author is not simply making this up.

Refer to my earlier comment about accuracy and context.

The Cochrane Review is a widely respected organisation who publish careful, reviewed, systematic meta-studies.

Here's a link to a metastudy about gastro-intestinal cancer and anti-oxidant supplements. (http://summaries.cochrane.org/CD004183/antioxidant-supplemen...)

That introduction is very clear. it is unambiguous. "Trial quality was exceptionally good". "Based on properly designed and conducted randomised clinical trials, convincing evidence that beta-carotene, vitamin A, vitamin C, and vitamin E or their combinations may prevent gastrointestinal cancers is not found [...] These antioxidant supplements even seem to increase mortality."

Here's the study for lung cancer. (http://summaries.cochrane.org/CD002141/antioxidant-drugs-for...)

Note that these people would really want to find effective cheap treatments for cancer, so it is in their interest to find that vitamin supplements work.

The trials show vitamins don't help cancer patients. They also show that OD-level supplementation of vitamins that are hard on the liver (vitamin A) increase mortality in cancer patients. That last part shouldn't surprise anyone. I'm sure if you give weakened people who already take chemo and whatnot, high levels of anything, mortality will increase.

They say nothing about the effects of healthy people, or the effects of lower (common) doses. I don't understand how the author jumps from that, to the concusion that multivitamin pills are bad for everyone.

Your answer is posted 9 minutes after my response.

Did you read the Cochrane meta study in that time? Did you read any of the original studies in that time?

I'm not looking for cheap ways to cure or prevent cancer. With that out of the way, I can talk about why I find references important.

> That introduction is very clear. it is unambiguous.

No it wasn't, on both counts. Vitamins A, D and E are widely known to cause hypervitaminosis. Of course I wouldn't want to over-eat those. What about C, that they mentioned?

Cohchrane Review might be widely respected. That does not mean that everyone who cites them does it accurately, with full context. If he had given links at the end of his rag, I could have verified the details for myself.

I agree that it is important to provide references.

You've already called him a scumbag. Thus, you won't trust whatever he provides. If he had provided a list of references you would have accused him of cherry picking.

The fact that you quibble with Cochrane reviews tells me all I need to know. (That this discussion is unlikely to be of any use or interest to me.)

> Of course I wouldn't want to over-eat those.

Did you read the meta-study? Did you read any of the original studies?

> You've already called him a scumbag. Thus, you won't trust whatever he provides. If he had provided a list of references you would have accused him of cherry picking.

Good job having a conversation with me all by yourself.

> That this discussion is unlikely to be of any use or interest to me.

Mutual. (The fact that you see pointing out of a logical gap as quibbling.)

> Did you read the meta-study? Did you read any of the original studies?

My point was about the missing reference in the NYT article. Given references, I draw my own conclusions.

"Vitamins A, D and E are widely known to cause hypervitaminosis."

I don't think so.

Might someone please provide me with documented cases of vitamin E hypervitaminosis (including the dosage level of course) in humans. I've never found one.

I've known persons who took 20,000 to 40,000 UI of vitamin E per day for six months and to all appearances benefited from it. Yes, you read that right, 20K-40K IU - about 100X the common 400 IU daily dose, which some consider high.

Chickens, on the other hand, seem to produce fewer eggs when given larger amounts of vitamin E.

My personal belief is that testing doesn't occur at levels high enough to show the true efficacy of vitamin E.

Here is a meta-analysis: http://annals.org/article.aspx?articleid=718049

I would like a clear documented case of vitamin E hypervitaminosis. That article, "Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality", hardly answers my request.

What I have found are obfuscated cases: cases where Vitamins D or A are taken simultaneously with vitamin E, or cases where the patient is in a disease state and/or is taking (often multiple) drugs, especially anti-clotting drugs.

I increasingly tend to believe that the only way a normal person can overdose on Vitamin E is to choke on it or slip on it.

"First of all, the author sells a book about vitamins being bad, so he's probably not being objective about it."

That's a cynical glass-half empty perspective. The other way to look at it is that he might be an expert...

For example, assuming this is the same Paul Offit...you could claim that his book on the importance of vaccination makes him non objective, which would be a silly claim given that he's widely considered a leading expert in the field of vaccination.

Edit:

I'm going to get a little more personal because, for some reason, your opening line really bothered me.

You're dismissing someone's opinion, in a field for which he holds an M.D., where he spent 25 years of his life building a vaccine against a disease which kills 600 000 children a year . You've been barely alive for that period of time and you've studied computer science....the guy's an expert. Doesn't make him right...but there's no reason to disrespect him by assigning him false motives.

I'm just adding to the body of facts here. There's an almost identical article by him in the Guardian linked below which contains a plug to his book. It feels a lot like a marketing campaign for his book which will be released next week.

Edit: what do any personal facts matter here? Could you please stay on-topic and not make this about me vs him, but more about the content of his article? On top of the logical fallacies[1][2] you're committing, I feel really creeped out that you're posting personal details about me.

[1]: https://yourlogicalfallacyis.com/ad-hominem

[2]: https://yourlogicalfallacyis.com/appeal-to-authority

That he's "probably not being objective" isn't a fact. You opened up with the ad-hominem, do you really not see that?

https://en.wikipedia.org/wiki/Ad_hominem#Ad_hominem

"Conflict of Interest: Where a source seeks to convince by a claim of authority or by personal observation, identification of conflicts of interest are not ad hominem – it is generally well accepted that an "authority" needs to be objective and impartial, and that an audience can only evaluate information from a source if they know about conflicts of interest that may affect the objectivity of the source. Identification of a conflict of interest is appropriate, and concealment of a conflict of interest is a problem."

There was just an article on the front page not too long ago about the misuse of logical fallacies, so thanks for correcting that for everybody. As a rule of thumb, an 'Ad hominem' is only fallacious when the 'attack' is irrelevant to the argument; probable motivation to exhibit bias is not irrelevant to the argument.

To be fair though, the author does not hide any conflict of interest - it is stated in the footer - and the argument is made with evidence, not simply "I've been a doctor for 25 years, listen to me!".

This is coming dangerously close to dismissing all arguments from experts because their expertise has made them "biased" or presents a "conflict".

"The other way to look at it is that he might be an expert..."

He is definitely an expert. From Wikipedia, he is a pediatrician, co-inventor of a rotavirus vaccine, and published more than 130 papers in medical and scientific journals.

http://en.wikipedia.org/wiki/Paul_Offit

"He is definitely an expert."

Medicine is a very big field. Indeed, so big that being a pediatrician, co-inventor of a rotavirus vaccine and publishing 100-odd papers doesn't make someone an expert on the very specific topic of human use of antioxidants. That is, unless the 100-odd papers are related to the human use of antioxidants.

He could be writing the book because he wants to make people aware.

I don't understand why people insist on taking supplements when they have no medical reason to do so.

From the bottom of the page:

"Paul A. Offit is the chief of the infectious diseases division of the Children’s Hospital of Philadelphia"

I can give you my reason: I take supplements because I'm positive I'm not getting 100% of my necessary vitamins from my diet/sunlight. Also because on some days I might need more, and on others less, so I make sure that I take enough for even the most "vitaminy-requiring days" (i.e. after infection but before symptoms of a disease, or after workout). That's why I take a dose that's higher than the RDA. There's almost no evidence contrary to taking higher-than-normal doses of vitamins, except for the ones that get stored in fatty acid such as VitA and VitD. For those I watch out that I don't take too much. On the other hand, there's a lot of studies done where people deficient in vitamins have lots of adverse health effects which they may not even be aware of. I figured that there's lots of potential benefits to gain from taking vitamin supplements, and if it doesn't work then I'm only out money.

>> there's a lot of studies done where people deficient in vitamins have lots of adverse health effects

Sure, that's why you should go for physicals. A doctor can have blood tests done to check, then you have a medical reason for taking them.

The doctor's check up might cost $200. I pay $60 a year for my vitamins.

First of all, the author sells a book about vitamins being bad, so he's probably not being objective about it.

I think you are reversing the cause and effect here. You assume that because he is releasing a book on this topic, therefore his opinion has been molded to fit the book. But you should be asking where the opinion behind the book came from originally.

Meanwhile, the reverse can also be true - the author, a highly credentialed doctor, started out objective on the topic and after years of research has come to the conclusion that he advocates in his article and book.

The focus here on "being objective" is a bit odd - not every issue has two sides that are both equally correct. The fact that someone has done all the research and looked at years of studies and has arrived firm conclusion does not automatically make him or her an unfair observer.

In fact, that's not even bias! Bias is refusing to consider any other viewpoint even with evidence.

I do agree with you though that the article would be better if it was more clear about the dosages in the studies. It's advice comes off as "vitamins are dangerous" rather than "megadoses of vitamins are dangerous".

If you're a scientist and objective observer you publish papers on a topic. You write a book to make money on that topic.

Writing a book is generally a terrible way to make money, especially given the salary he must be making now.

Another motivation besides greed could be wanting to warn people and potentially save many lives.

Luckily for the publishing business, most would-be authors do not realize that.

First of all, the author sells a book about vitamins being bad, so he's probably not being objective about it.

Ok, but that standard applies to any researcher who receives grant money or a salary. In fact, it's so high a standard that objectivity can be claimed by no one. Which is probably accurate, but not very useful for making distinctions—it's a case of what Hegel called "the night in which all cows are black".

Of course he's not being objective about it! He's being sensationalist.

If you go and look for studies on vitamins increasing mortality, you will find them. If you look for studies on vitamins increasing longevity, you will find them.

Seems the author is choosing to present only the former, though!

Paul Offit seems to be irrationally biased. In his longer guardian piece on the same topic he is extremely selective in his referencing of the scientific literature. This is his summary of the findings on one popular herbal treatment for depression:

"Depression is a serious illness; to treat it, scientists have developed medicines that alter brain chemicals such as serotonin. [...] Alternative medicine practitioners, however, have a better idea – a more natural, safer way to treat depression: St John's wort. Between November 1998 and January 2000, 11 academic medical centres randomly assigned 200 outpatients to receive St John's wort or a placebo, finding no difference in any measure of depression."

He omits the fact the same study also did NOT detect any effect of Sertraline/Zoloft (one of the very medicines he refers to so approvingly):

"Neither hypericum nor sertraline could be differentiated from placebo on the primary efficacy measures."

This points to a lack of statistical power in the study (which the authors of the study acknowledge).

He also omits to mention the many studies showing st john's wort to be as effective as SSRIs, with fewer side effects (eg see the cochrane summary here http://summaries.cochrane.org/CD000448/st.-johns-wort-for-tr...).

I don't trust this author.

The author has a pretty big conflict of interest that he doesn't disclose. He invented one of the major vaccines, regularly consults for pharmaceutical companies, etc. If an alternative to vaccines was found to be effective in preventing or treating diseases, he would have much to lose.

He would have very little to use. He helped create one vaccine. His royalties are not that significant (according to him). He'd have just as much to gain from scientifically valid alternatives if they existed. He could do the same as he does now (treat patients, speak, and write) with any valid disease treatment.

This article feels annoyingly incomplete or very poorly edited.

In December 1972, concerned that people were consuming larger and larger quantities of vitamins, the F.D.A. announced a plan to regulate vitamin supplements containing more than 150 percent of the recommended daily allowance. Vitamin makers would now have to prove that these “megavitamins” were safe before selling them. Not surprisingly, the vitamin industry saw this as a threat, and set out to destroy the bill. In the end, it did far more than that.

Industry executives recruited William Proxmire, a Democratic senator from Wisconsin, to introduce a bill preventing the F.D.A. from regulating megavitamins. On Aug. 14, 1974, the hearing began.

Speaking in support of F.D.A. regulation was Marsha Cohen, a lawyer with the Consumers Union. Setting eight cantaloupes in front of her, she said, “You would need to eat eight cantaloupes — a good source of vitamin C — to take in barely 1,000 milligrams of vitamin C. But just these two little pills, easy to swallow, contain the same amount.” She warned that if the legislation passed, “one tablet would contain as much vitamin C as all of these cantaloupes, or even twice, thrice or 20 times that amount. And there would be no protective satiety level.” Ms. Cohen was pointing out the industry’s Achilles’ heel: ingesting large quantities of vitamins is unnatural, the opposite of what manufacturers were promoting.

A little more than a month later, Mr. Proxmire’s bill passed by a vote of 81 to 10. In 1976, it became law. Decades later, Peter Barton Hutt, chief counsel to the F.D.A., wrote that “it was the most humiliating defeat” in the agency’s history.

Well, what more did the industry do than destroy the bill? After making such a strong clear case for regulation, how did the bill forbidding it pass with such an overwhelming majority? Were there payoffs, or was it something the vitamin makers said in testimony, or did they gin up a massive publicity campaign, or what? I'm quite frustrated at how little information this article contains.

On the plus side, I'm glad that I've stuck to getting my vitamins from food rather than supplements.

Why hasn't this issue been revisited in congress? Shouldn't everything be revisited very X years to ensure that the law is still relevant with current information?

The are a great many laws I would prefer the current Congress not revisit.

I see your point and it's an unfortunate situation.

Shouldn't our representatives be the smartest and most upstanding citizens available? How do we make that a reality?

I found a few sites similar to these:

www.popvox.com

www.opencongress.org/bill/all

The article does not seem to follow the headline. Supplement manufacturers going on the offensive has nothing to do with the safety of vitamins.

> Well, what more did the industry do than destroy the bill?

I don't want to talk about a monolithic "The Industry". But there's no doubt that some companies and people involved in mega-dosing or in vitamin supplements are evil. I don't mean wishy-washy "making lots of money and being a bit cynical" kind of evil, I mean actually evil.

Mathias Rath has probably caused the death and infection of very many people in South Africa because of his AIDS denialism and promotion of vitamins as a cure for AIDS. (https://en.wikipedia.org/wiki/Matthias_Rath)

(http://www.irinnews.org/report/38577/south-africa-controvers...)

(http://www.irinnews.org/report/78739/south-africa-tac-prevai...)

Remember that this was during mid to late 2000s when HIV / AIDS was a significant killer in South Africa, infecting nearly a third of the population (http://www.avert.org/south-africa-hiv-aids-statistics.htm)

Patrick Holford has written books with titles like "Food is better medicine than drugs: your prescription for drug free health" - people are turning away from conventional medicine and using multivitamins. He's not as scummy as Rath, but he's pretty scummy. Selling vitamins as a cancer-cure to desperate people when there's no evidence that it works is unpleasant.

The article gives calm, sensible advice.

It misses the importance of (normal quantities of) Vitamin D. Many people live in places where they're unlikely to get correct amounts of Vitamin D, especially because of the (correct) caution about sun exposure and the move away from dairy fats.

For those people a Vitamin D supplement is a good idea.

Also, women wanting to become pregnant should strongly consider folate supplements.

And children probably need (correct child dose) multivitamins up until about 4 or 5 years old.

EDIT: Some sources.

UK National Health Service: (http://www.nhs.uk/conditions/pregnancy-and-baby/pages/vitami...) - notice how it stresses the importance of healthy diet, but also advises for Vitamin D supplements.

Scotland: Warning over Vitamin D levels (http://www.bbc.co.uk/news/uk-scotland-11355810)

It's simple enough to get a test for deficiencies, then take the specific supplements you need, if you need them.

Is it simple like a urine pregnancy/drug screen test that gives quantitative recommendations?

Or is it more like arrange with your doctor to draw some blood, have it tested, then get an expert appraisal of the results which recommends a set of supplements?

Either way, it should probably be done periodically, to account for changes in diet and personal circumstances.

I wonder if this is something that personalised medicine could start with -- A machine which combines the blood analyser, expert system for determining requirements, and a set of dispensers that load the exact quantities into capsules while you wait. Ideally it'd work with something like a glucose test finger-prick sample, but I have no idea how much blood you need to run some of the more complex blood analyses.

>>Is it simple like a urine pregnancy/drug screen test that gives quantitative recommendations?

Not that I know of, you have to get blood drawn.

>>A machine which combines the blood analyser

Yea, that would help a lot.

Living in the Great White North (Canada), pretty much every health group ever recommends a vitamin D supplement because we get so little sunlight. As an office worker, this goes double for me.

Also conspicuously missing from their list are vitamin B supplements; as a vegetarian I take B12, but they don't make any comment on whether this could have similar effects.

All the referenced studies (none of them are behind a paywall):

The Beta-Carotene and Retinol Efficacy Trial: incidence of lung cancer and cardiovascular disease mortality during 6-year follow-up after stopping beta-carotene and retinol supplements.

http://www.ncbi.nlm.nih.gov/pubmed/15572756

Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis.

http://www.ncbi.nlm.nih.gov/pubmed/15464182

Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality

http://www.ncbi.nlm.nih.gov/pubmed/15537682

Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial.

http://www.ncbi.nlm.nih.gov/pubmed/15769967

Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study.

http://www.ncbi.nlm.nih.gov/pubmed/17505071

Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases.

http://www.ncbi.nlm.nih.gov/pubmed/18425980

Dietary supplements and mortality rate in older women: the Iowa Women's Health Study http://www.ncbi.nlm.nih.gov/pubmed/21987192

Effect of Hypericum perforatum (St John's Wort) in Major Depressive Disorder A Randomized Controlled Trial http://jama.jamanetwork.com/article.aspx?articleid=194814

Interestingly, the opposite is true for vitamin D. For years, study after study shows that most people are severely deficient in vitamin D and that supplementation helps. Yet, officially recommended doses are way below the levels that scientists recommend.

And importantly, a lot of countries do have laws against mega doses, causing pills with more than 150% of RDA to be illegal, making it really hard to get a decent supplementation, especially during winter.

In a case like that, what prevents somebody from taking more than one pill at the same time, if one pill alone is insufficient?

Nothing, but it becomes quite expensive.

Do not use this article as an reason to stop taking Vitamin D. Totally different thing altogether. This article demonstrates the problem with calling all of these things "vitamins."

Ok, what looked liked a passable article shows some new things:

"The likely explanation is that free radicals aren’t as evil as advertised. (In fact, people need them to kill bacteria and eliminate new cancer cells.) And when people take large doses of antioxidants in the form of supplemental vitamins, the balance between free radical production and destruction might tip too much in one direction, causing an unnatural state where the immune system is less able to kill harmful invaders. Researchers call this the antioxidant paradox.""

I wouldn't be worried at 150% vitamin dosages, worry if it's 1000% of the daily dosage (and some people take huge doses of Vitamin C with no major side effects. But if you do that with Vitamin A, yes, this could be very troublesome)

Not taking one side or the other, it's important to note that when it comes to nutrition, we know very little. Or rather, we know many disparate facts but very little about how they interact. The reason is that there are very few good "unit tests" for human physiology, and we're not even sure about what they really mean (for example, current research suggests that what we thought we knew about the significance of blood cholesterol levels might be wrong). And if all we have are "integration tests" (like mortality rates), the number of variables affecting them becomes so huge, that in order to get truly statistically significant results we would need to conduct randomized trials on very big populations. Add the difficulty of conducting a double-blind randomized nutrition trial even on a small population, and you get results that have little actual "results" (although a randomized double-blind trial with vitamin pills is possible).

When John Ioannidis proved that most published medical research is false[1], he singled out genetics and nutrition[2] as the two most problematic fields, where very, very few findings are true. The fact is that we know alarmingly little about what constitutes a healthy diet. Let me clarify: we know hardly anything about significant difference in total health one relatively "normal" diet has over another. Ioannidis's advice: completely ignore any nutritional "scientific" claims because they are anything but. Any supposed claims for "healthy" eating are no more than wishful thinking, pseudoscience and good-old snake-oil salesmanship.

What is interesting from a scientific point of view, and this is one subject we know a lot more about than actual nutrition, is why people who are otherwise scientific minded skeptics are superstitious when it comes to nutrition (if you believe that eating more green vegetable or less, consuming more vitamin C or less, more saturated fat or less is actually better for you, then you are superstitious, unless you are knowingly placing a scientifically unfounded bet on one diet over another).

Obviously, the well-known psychology of magical thinking applies to everyone, and even skeptics are not immune to it (Charles Darwin, if one anecdote about him is correct, quite amazingly identified the effect magical thinking had on his own research, and took measures to counteract it). But why is food such a focus of superstition among skeptics? It probably has to do with their political leaning.

Jonathan Haidt hypothesizes that the value of "purity" is ingrained in human existence, and every society seeks to fill it with particular meaning[3]. Because liberals wholly reject giving "purity" sexual or racial content, they choose to purify themselves through health, and in particular, food. It seems that people have such a strong desire to feel pure, that those that cannot achieve it through religious means, try to achieve it with food. And because food is, after all, subject to scientific study (though mostly bogus), it gives that little something to grab onto and construct magical thinking around.

Consider this if you don't believe me: pick one scientific nutritional finding that you particularly like, and have chosen to adhere to. Let's suppose that the finding is true as published. Now, look at what statistical effect-size that particular research claims your chosen diet has. For example, by how much does it prolong life? 10%? 5%? 3%? Or by how much does it reduce the risk of getting a particular form of cancer? Does it take it from 1/100 to 1/10000? Or, perhaps, from 1/1000 to 1/1200?

Now think if in other areas of life, such effect-sizes would change your behavior as much.

Theres definitely a lot of psychology when it comes to people's diets. Science? Not so much.

[1] http://www.plosmedicine.org/article/info:doi/10.1371/journal...

[2] http://www.theatlantic.com/magazine/archive/2010/11/lies-dam...

[3] http://www.ted.com/talks/jonathan_haidt_on_the_moral_mind.ht...

What counts as scientific evidence has fairly high standard. What we know may not reach that level of rigor, but isn't it still a bit more than 'very little'.

If, say, it's 80% (rather than 95%) likely that eating more than 4 servings of fruits and vegetables per day helps reduce your chance of having cardiovascular diseases by 35%, and you don't mind the food group anyway, why shouldn't you try?

In any case, there are very few (or no?) studies that say eating a lot of vegetables and fruits (within reason) will cause you health problems.

A principle of entrepreneurship is that whenever a bet yields either positive or neutral results, you should do it. Why shouldn't this principle be applied to such an important area as our health and wellness?

There's actually evidence to support that eating fruit is quite detrimental to your health, as modern fruit contain so much sugar. What are you eating fruits for? Water? Vitamins you can get from meat anyway? A lot of people say fruits are bad for you.

Now, I'm not saying you should or shouldn't do one thing or another when it comes to nutrition. All I'm saying is you should be aware that it's little more than superstition and magical thinking. It's very hard to resist magical thinking, but it's often good to know when you're doing it. Sometimes doing things with your eyes open is better than doing them with your eyes shut. Although in this case I'm not 100% sure about that: there's clearly a lot of (positive) placebo effect at the cause of many anecdotal reports about nutrition, and knowing that it's mostly superstition may negate it.

> There's actually evidence to support that eating fruit is quite detrimental to your health, as modern fruit contain so much sugar. What are you eating fruits for? Water? Vitamins you can get from meat anyway? A lot of people say fruits are bad for you.

Is there?

As far as I know, there is evidence about sugar but not about fruit. And assuming that evidence about sugar translates to evidence about fruit is exactly the kind of sin your first post talks about.

(But if you can point me to experimental evidence specifically about fruit, I'd be very interested in reading that)

Current fruits are with much higher sugar content than in generations past. So you are pumping yourself with fructose much faster.

I suppose that might be true (though I don't assume that -- references will be appreciated).

However, that does not at all address the question of whether or not they are healthy for you or not.

Fructose on its own is associated with all kinds of problems. But a fruit is not fructose on its own, and it's possible that other things in fruit make fructose "not a problem".

e.g.: Table sugar is 50% fructose - however, it is not associated with the same kind of problems that pure fructose is associated with.

e.g.: Table salt, Sodium Chloride, is harmless (actually, essential) in small amounts - however, just the same amount of chlorine (if you managed to take the sodium away somehow) will easily kill you. And I don't know, but I'm sure pure sodium if ingested wouldn't be health for you either.

So, the question stands: Is there evidence that fruit is bad for you? Even suggestive evidence? A study of comparable populations whose main difference is the amount of fruit eaten, which shows that the less-fruit-eating population is better off?

Anecdotal evidence how sweet current fruits are - the difference between wild apples, cherries and strawberries and the ones you can buy in the supermarket.

First about the salt - NaCl is salt so it is chemically quite inert you will have hard time breaking it unless you pump quite a lot of energy (or use elements that are more chemically active than either Na or Cl and there aren't many (lithium, fluorine, hydrogen).

Chlorine is very potent oxidizer that will wreak havoc in all kind of processes.

Sodium will just try to make your intestines into soap - quite unpleasant thing.

But they are chemically different elements.

Fruits are not bad for you in the same way most of the food is not bad for a healthy person. But if you are a person with the metabolic syndrome, high insulin resistance or type 2 diabetes you just cannot assume that a diet of only bananas, ultra sweet apples, pomelo, peaches etc will do you much good.

Of course fruits have the benefit of containing lots of water and pulp so they are digested slower than a can of coke with the same sugar amount which is good.

If you are healthy person eat fruits freely. If you are not be careful with the blind assumptions that they are good for you. Ask someone with great knowledge about human metabolism specifically for your case.

I appreciate your answer, but I feel the need to point out that the original question still stands unanswered. Is there any evidence, weak as it may be, that FRUIT consumption is harmful in any way? (note: not that FRUCTOSE consumption is harmful. I'm aware of that. I'm looking specifically for FRUIT consumption).

> the difference between wild apples, cherries and strawberries and the ones you can buy in the supermarket.

Anecdotal, of course, but while I haven't had a chance to pick wild apples or cherries, I did have a chance to pick wile strawberries, raspberries and blackberries - and they were just as sweet and perhaps even sweeter than those I buy at the supermarket. They _were_ much smaller and not as nice looking, but were extremely sweet. Similarly for grapes.

I know for sure that e.g. industrially grown tomatoes have been optimized for size and looks at the EXPENSE of sugar (and other nutriet) content. This might also be true for other fruits and vegetables.

> NaCl is salt so it is chemically quite inert

That's exactly my point. It's possible that fruit is "inert" in its sugar effect - studies about pure fructose consumption are potentially irrelevant.

> But if you are a person with the metabolic syndrome, high insulin resistance or type 2 diabetes you just cannot assume that a diet of only bananas, ultra sweet apples, pomelo, peaches etc will do you much good.

Of course, but that's begging the question. If you are a person who suffers from hypertension, than you cannot assume that regular salt intake is good for you! But it is, for 80% of the cases - the remaining 20% being the salt-sensitive hypertension people.

You cannot assume that such a fruit diet will do much bad either. Doing so is blind faith. And that's exactly pron's point.

> Ask someone with great knowledge about human metabolism specifically for your case.

I've been looking for someone like that, but it seems that there are non to be found. Specifically, everything about my metabolism falls outside accepted wisdom; You'd expect the experts to want to look at evidence contradicting their predictions to learn to improve their predictions - but after talking to 30 or so "experts", I have not found one who has such an interest.

Pure sodium is an extremely reactive metal. It's so reactive that it doesn't occur in nature - for example, if you drop it in water, it'll explode. (http://www.youtube.com/watch?v=ODf_sPexS2Q)

So, yes, it's probably lethal.

This line of discussion rather proves the original point. We don't know if unbounded fruit consumption is bad. Of course unbounded simple sugar consumption is (we think) but some evidence has shown that for whatever reason, sugars directly from fruit enter the blood stream slower. Maybe. :-)

> e.g.: Table sugar is 50% fructose - however, it is not associated with the same kind of problems that pure fructose is associated with.

Table sugar consumption is indeed bad for you only because of its 50% of fructose.

So, you claim that pure glucose has no known health problems associated with it? (If I understand correctly this is an equivalent claim to what you say, since the other 50% is glucose).

A random google search (e.g. see http://www.lef.org/magazine/mag2011/jan2011_Glucose-The-Sile... ) indicates that this belief is not part of the consensus. Care to back that up?

"There's actually evidence to support that eating fruit is quite detrimental to your health.."

If there is actual evidence, please cite it. I've never heard fruit proclaimed as bad for you. In fact, every major healthly eating initiative or campiagn (whether from governments, the World Health Organisation, or NGOs) always recommend consuming more fruit and vegetables as part of a healthy diet.

The fructose in fruit is not the same as high fructose corn syrup found in many processed foods. Yes, fruit can contribute to acid erosion on teeth, but this is also dependent on the type of fruit, the quantity you eat and when you eat it (e.g. eating fruit with a meal can lessen the impact of the sugar). Eating fresh fruit is always preferable to dried fruit or fruit juices.

Do you have any evidence for your claim that fructose in fruit is different from fructose in corn? Absent such evidence, you're just repeating the same magical nutrition claims this thread is about, and name dropping the WHO does nothing to change that.

Here's an interview with a UCSF professor who claims fructose in all its forms is a problem: http://www.sciencefriday.com/segment/01/11/2013/the-fallacie...

Also http://www.sciencefriday.com/segment/01/11/2013/the-fallacie...

Please note that while Professor Lustig's claims about the wholly toxic nature of fructose are not accepted as fact (see http://www.ncbi.nlm.nih.gov/pubmed/20047139 and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411192/ for a couple of examples), I think you're still miscategorizing his claims. Please see:

http://www.crsociety.org/index.php?/topic/291-dr-lustig-on-f...

"I think that fruit is so much better a choice than virtually anything else in the store -- particularly any processed food -- that I don't want to come down on it. But I would say, fruit is one of those things where I would say, everything in moderation."

This sort of falls into the "duh" category. Just as a sensible person wouldn't consume a ton of saturated fats in the name of eating a high protein diet, a sensible person is not going to be eating 20 bananas and five pounds of strawberries a day in the name of getting enough fruit.

As for the professor's claim that exercise isn't effective for weight loss, I think laypeople should be aware of the tendency for academics to speak in macro terms. The vast majority of people I have met who are overweight and have tried unsuccessfully to lose weight a) do not have as healthy a diet as they believe they do (far too many processed foods) and b) if they exercise and exercise consistently (a big if), do not exercise long enough and intensely enough to burn fat and become conditioned.

Anecdotal? Yes, but instead of blaming specific foods and claiming that exercise isn't effective, let's just be honest: most people won't lose weight because they can't commit to major changes in their lifestyle.

I think it's funny that you're citing all of these studies and generally being evidence-based and rational and then you casually mention that "processed food" makes people fat.

Well this whole discussion, especially debunking citations with citations, pretty much is a big evidence in favour of the original thesis - we don't know for sure pretty much anything about nutrition.

I didn't write that. I wrote that in my own experience, most of the people who are overweight who try unsuccessfully to lose weight a) don't have as healthy a diet as they'd like to believe and b) don't exercise long enough and intensely enough if they work out at all.

What is a "healthy diet"? I don't believe there's a one-size-fits-all answer, but I mentioned processed foods because at the highest level, there is plenty of evidence that processed foods are problematic when consumed in the quantities they are being consumed in:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897733/ http://news.yale.edu/2013/03/06/yale-researchers-identify-sa... http://www.biomedcentral.com/1741-7015/11/63 http://www.diabetes.org/news-research/research/access-diabet... http://jn.nutrition.org/content/139/10/1950 http://wholegrainscouncil.org/whole-grains-101/health-studie... http://www.sciencedaily.com/releases/2012/02/120210110038.ht...

OK, this is a pretty ridiculous claim. Other people have already pointed out, "There's actually evidence" requires some evidence. You have none.

Why would modern fruit contain "more sugar"? More sugar than when? How much more sugar? Who miraculously put the extra sugar in the fruit? The fact is, even if we selectively bred fruit to be sweeter, we're not going to get it much sweeter than it already was. Nobody's going around injecting apples with extra fructose with a syringe.

Getting all your vitamins from meat is ridiculously inefficient; you can do it, but you're creating a tremendous ecological burden. All of that meat has to be raised, fed, watered, and pastured. Fruits and vegetables cut out the middle man; they use much less water and land to get the same nutrients into your body.

It's fine to say that 'magical thinking' is bad, but you're not doing any better. If anything you're ignoring facts based science in favour of 'what some people say'.

Ok, I wasn't not trying to insult fruit or anything, and I was referring to research about sugar, which some other commenters are debating. Just saying that it's not even clear cut that eating fruits is particularly healthful.

And regarding "Getting all your vitamins from meat is ridiculously inefficient" -- you are trying to hack the unhackable, speaking in scientific terms about things we have little clear scientific understanding of. "Fruits and vegetables cut out the middle man; they use much less water and land to get the same nutrients into your body." -- Nope; you don't know that. Some people believe that, some don't.

For all we know, such careful nutritional hacking has little, if any, effect on our health. That's what we know. What people believe is a whole other matter. Most of the diet-talk we hear is just catechism of a new religion (and there's nothing inherently wrong with that, except that pseudoscience is a little annoying) and a whole lotta politics (in this case, it's fascinating to see liberals defending pseudoscience, while conservatives discard it, maybe because they believe the liberals who believe it's actual science). Science it ain't.

As I understand it, fructose in fruit tends to be offset by the fact that fruits have fibre. The fibre means the fructose is kept in your gut for longer, and bacteria there break it down before it has a chance to hit your liver. The issue with fructose/sucrose tends to arise when we have it in liquid format (juices, soft drinks etc.), or eat large quantities of foods high in sugar without the accompanying fibre.

> Why would modern fruit contain "more sugar"? More sugar than when? How much more sugar? Who miraculously put the extra sugar in the fruit?

Selective breeding, of course. Modern vegetables are, in general, less bitter than in earlier times. Fruits are often sweeter---and easier to farm industrially and bring to market. Also, we live off less different kinds of fruit and vegetables than in earlier times. There used to be hundreds of different apples in widespread use for examples.

Not saying that it's necessarily bad. Just that pron's hypothetical argument isn't actually all that hypothetical.

> Modern vegetables are, in general, less bitter than in earlier times.

That does not necessarily mean more sugar - it just means less bitter. (These axes are independent).

Selective breeding puts pressure on easy-to-grow-and-sell (shelf life, size, shape, resistance to pests) and only afterwards on flavor.

And another important (and often forgotten) point about modern frutis and vegetables is that they are mostly picked when green (when not all sugar has ripened yet), and then chemically ripened in a process that does not yield as much sugar as natural ripening.

I would like a reference before I believe that today's fruits and vegetable contain more sugar than those of 50 years ago.

Oh, sure, wasn't meant as a reference, but just some evidence that it's not totally implausible.

This is very loose wording. "Evidence" this is not. It is an argument supporting an idea, which is still therefore hypothetical.

A few broad facts are well known, but our knowledge is still quite limited.

> A principle of entrepreneurship is that whenever a bet yields either positive or neutral results, you should do it. Why shouldn't this principle be applied to such an important area as our health and wellness?

It's not only positive or negative expected value, but rather that the uncertainty (i.e. variance) outweighs the expected value of almost all detailed propositions.

After you took care of the simple and uncontroversial things, e.g. adequate amount of calories, enough iron etc, there's not too much we know how to optimize in general.

When it's a neutral thing for you, sure, why not. However, most things about nutrition are NOT neutral.

Is salt bad for you? (hint: unless you have a very specific hypertension condition, all the bad things you heard about salt are not relevant to you)

How much is too many eggs per day? (hint: no known limit. Cholesterol from eggs was never shown to be a problem)

Well, how about butter and fat? (hint: right kind of butter is good for you, as is the right kind of fat)

But surely, saturated fat is bad for you! (hint: no proof of that)

But at least bacteria and dirt are bad for you, I'm sure of that! (hint: life span is correlated with eating lots of fermented - i.e. bacteria laden foods. Also, people who work in sewage have higher life span and less illness overall)

You are taking tens or even thousands of bets based on bogus research without even knowing that. It is not unreasonable to assume that washing your hands all the time and keeping your house clean significantly raises the probability of autoimmune disease.

And really, if you go through nutrition literature and try to trace the knowledge to repeatable and demonstrable experiments, you'd agree with "very little". e.g., the calorie marking system used on foods is based on bomb calorimeter experiments (which you can debunk at home) and atwater factors (which have been shown to be grossly inaccurate, as in tens to hundreds of percents).

Right on. In fact, I think there's little conclusive evidence linking dietary (ingested) cholesterol to heart disease (though, if I'm not mistaken, there is some/strong? evidence linking blood cholesterol to heart disease).

It's best to assume all nutritional claims are bogus, because the vast majority of them probably are, and there is no way for us to tell which at this point.

> , if I'm not mistaken, there is some/strong? evidence linking blood cholesterol to heart disease

Cholesterol is ultimately used (and therefore made) by the body in an attempt to heal conditions that cause heart disease (The main use is for making vitamin D, whose other ingredient -- sunlight -- is in short supply for most people in the western civilization).

Thus, cholesterol is a good marker for pending problems, but is not itself the problem.

Analogy: People who take an advil are likely to report a headache 1 minute after taking it. Therefore, seeing someone take an advil is a good indication for a headache. But it is not the cause of the headache - and in fact, banishing all advil will not make anything better. But somehow, people think that banishing cholesterol will -- despite evidence to the contrary.

(Yes, statins do decrease heart disease, but they increase all cause mortality. And there have so far been many cholesterol-decreasing drugs developed - but none other than statins have decreased heart disease)

> It's best to assume all nutritional claims are bogus, because the vast majority of them probably are, and there is no way for us to tell which at this point.

"I don't know anything about ____. Therefore all these claims the so-called experts are making about ____ are clearly bogus!" This kind of dismissive line of thought (there are some variations on the theme - many people don't like to admit that they don't know something) pops up in a lot of areas and it is pretty embarrassing.

In the real world when I meet people with attitudes like this, it invariably says a lot more about the person than the supposed inscrutability of the topic under discussion. The narcissism to dismiss entire lines of study and the lack of curiousness of someone who hasn't bothered to form an opinion on which ideas are better than the others... even when you hang out with a community of avowed skeptics, these attitudes really help separate the wheat from the chaff.

That's nice. Read the thread. TL;DR: It's been proven (though some dispute it) that almost all nutritional research is false. That research's validity is pretty close to that of homeopathy.

It's peculiar that you cite Ioannidis's work as having "proven" your utterly defeatist position. Your point is that there's no way anything could be learned with nutrition studies, his point is that there's very much a correct way to learn things with nutrition studies and a method for evaluating the quality of such studies to make sure they're doing it right.

He doesn't advocate that we give up, crawl into the fetal position, and stop trying to understand the world any more than any of the other popular statistics skeptics do.

Neither does prom advocate that. He just said existing research is mostly wrong. That's not defeatist, that's realist.

That's not actually what he said.

I maintain that there's a meaningful difference between "often wrong" and "almost all" wrong and "assume all claims are bogus" and "view claims skeptically." One approach is a license to intellectual laziness (defeatist) and the other requires effort but can reap benefits.

It sounds like you're suggesting that people eat as much salt as they like. Where's the harm in cutting back on the salt?

I agree with you that a lot of our diets (especially fad diets) are based on little to no science. At best, they're based on incomplete science. But what dietary guidelines would you recommend to someone?

Personally, I try to follow Michael Pollen's advice (Eat food. Not too much. Mostly plants.), whether or not it's based in complete science. Because with diet, one can't simply wait for science to settle things out.

> It sounds like you're suggesting that people eat as much salt as they like. Where's the harm in cutting back on the salt?

Cutting too much on salt is indeed harmful http://en.wikipedia.org/wiki/Hyponatremia - up until 30 years ago or so, hyponatremia because of too little salt intake was virtually unheard of in the west, and now it is rare but not unheard of, because some people take the "cut back on salt" recommendations seriously.

What's the harm in eating only bland food? No harm. Also no harm in cutting back on listening to your favorite music. But why on earth would you do that? It's no different than avoiding alcohol or pork for religious reasons, or not driving on a saturday for the same religious reasons. If you like it, no one is stopping you. But it is based on blind faith, rather than science.

> But what dietary guidelines would you recommend to someone?

I was going to quote Pollen, but you beat me to it :) I think another recommendation from Pollen is helpful: "Do not eat anything that your grand-grandmother wouldn't have recognized as food".

Personally, given that I've found so much evidence that the "common knowledge" is wrong, I look at the fringes hoping to find something more useful. To that end, I recommend following the blogs (and mostly, but not exactly, the advice) of Dave Asprey (Bulletproof Executive) Tim Ferris (4 Hour Body) Paul Jaminet, Gary Taubes, Stephan Guyonet, Mark Sisson ... start browsing any of them and you'll find the others.

Interesting. But is obsessively eating healthy really tied to political leanings? As far as I can tell it seems to be mostly a upper middle class thing (perhaps coincidentally the class mostly everyone believes they're in).

That said, I suppose I could make the same argument that many people with a certain political leaning do engage in self-mandated food purity by eating vegetarian or vegan. Which sound reasons and very little magical thinking in terms of the economics of food.

sound reasons and very little magical thinking in terms of the economics of food

First, there isn't much logical thinking involved in veganism or vegetarianism. At their best, they're about ethics (which I certainly respect). At their worst, they make some very dubious claims about te economics of food and the environment.

But either way, note that people make significant and probably burdensome changes to their lives when it comes to upholding morals pertaining to food. I think that more (liberal) people would go a longer way making actual life changes when it comes to food than just about anything else. They might explain that the things you actually put into your body are the things you should care about most. Only there's little evidence to suggest that's the case. It is much more probable that national policies like increasing minimum wage or reforming education would have a bigger (though indirect) effect on your personal well being than optimizing your diet (as long as it's more or less "normal").

All religions, in this case the healthy diet religion, must not rely on facts in order to gain followers; they must rely on gut feelings, because gut feelings are much more powerful than proof when it comes to motivating life changes. And we just naturally feel that ingested food has to have a major effect on our health and general well being. It just makes sense, right? But, at least in the current state of scientific knowledge on the subject, that intuition is just superstition. After decades of research there's little consensus even on what makes us fat, let alone more subtle or indirect effects diet may have on our health. In fact, it's very probable that even if one day we do know exactly what's healthy to eat and what isn't, and at what quantities, the actual effect-size on our health will be quite small. It's quite possible that within some sane bounds, what food we eat simply does not determine our health to any large degree.

    First, there isn't much logical thinking involved in veganism or vegetarianism.

I strongly dislike the flavor and aroma of meat, so it's logical that I follow a vegetarian diet.

(There are few things as useless as discussions about nutrition at Hacker News.)

But you would maybe eat meat if the flavor/aroma were OK, no? I realize this is getting into a 'duck typing' sort of question but I don't think "I just don't like the taste of meat" is really what most people think of by vegan/vegetarian.

I don't eat mashed potatoes, but it's not because of some reverence for the humble potato or concern about industrialization of farming, it's just because I don't like the taste.

That is actually NOT logical though. You have conditioned yourself to dislike the taste and smell of meat. You might as well say that a dog salivating when it hears a bell is logical.

Of course it's ok, and in a lot of cases, preferable, to not behave logically.

I disagree with your claim that veganism and vegetarianism can't be backed by logical thinking. Producing meat requires significantly more natural resources (land area, water) and produces significantly more pollution (methane, ground contamination) than producing fruits and vegetables.

Here is an example comparing the amount of water needed to irrigate various crops compared to the amount needed to raise beef.

US Corn Production: 9 gallons water / lb corn

US Wheat Production: 14 gallons water / lb wheat

US Barley Production: 26 gallons water / lb barley

US Alfalfa Production: 31 gallons water / lb alfalfa

US Beef Production: 441 gallons water / lb beef

http://www.journalofanimalscience.org/content/71/4/818.full....

Global Spinach Production: 2 gallons water / lb spinach

Global Potato Production: 4 gallons water / lb potatos

Global Banana Production: 13 gallons water / lb bananas

Global Apple Production: 18 gallons water / lb apples

Global Lentil Production: 64 gallons water / lb lentils

Global Cashew Production: 121 gallons water / lb cashews

Global Almond Production: 252 gallons water / lb almonds

http://www.waterfootprint.org/Reports/Mekonnen-Hoekstra-2011...

I could look for more examples, but this took me about half an hour already, and I think it pains a rather compelling picture by itself. The difference would be less extreme when looking at pork and poultry, but there is still a stark contrast.

You need to normalize to nutritional value rather than weight.

But the whole point of this thread seems to be that such an analysis is hard to do.

Exactly.

There are so many confounding variables here that it's really hard to tell. Everyone pretty much chooses to believe whatever data they like best. For example, cultivated land is probably less environmentally friendly than pasture land.

It wouldn't matter how environmentally unfriendly it was to cultivate land as long as livestock are fed cultivated crops, since they require more than one pound of food to produce one pound of meat.

If x = environmental impact of cultivating crops

then R*x = environmental impact of raising livestock

where R = pounds of feed required to produce one pound of meat

Now if we raised our meat differently, such as only on grass-fed pastures, then things might look a lot different. But in the US at least, factory farming and animal feed is the norm.

I'm not too fond of factory farming, but that has little to do with veganism. In any case, your math would be correct only if 1 pound of vegetables consumed by a person is the same as one pound of meat. I guess even vegetarians would admit that's wrong (I think humanoids started eating meat because it was the only thing providing enough concentrated nutrition to support a massive brain, at least without eating all day long).

Moreover, it's quite conceivable (again, no proof, but there's little proof af anything in this field) that herbivores would convert one pound of corn much more efficiently than we would. This might mean that humans are better off wasting energy by feeding vegetables to animals and then eating the animals, than eating the vegetables directly. Maybe we can't extract the nutrients from the vegetables as well as herbivores do, so that seemingly wasted energy is actually a net gain.

Energy is always lost as you move up the food chain, because no predator can capture 100% of the energy stored in their prey.

Consuming plants is not as efficient as photosynthesizing, and consuming animals is not as efficient as consuming plants.

In this case, the cows burn energy from the food they consume for as long as they're alive, meaning it's a physical impossibility for the meat produced from them to contain as much energy as the food they consumed.

Unless you're claiming that raising livestock violates the laws of physics, but that's an entirely different argument.

No, he's suggesting that it's possible humans digest plants much less efficiently than herbivores do, and less efficiently than humans digest meat. E.g., if the herbivore can capture 90% of the energy in a plant, and we can capture 80% of the energy in the herbivore, that may be a better deal than if we can only capture 10% of the energy in the plant directly. In the case of cows eating grass, that doesn't sound that far-fetched. They have the benefit of multiple stomachs evolved to break down fibers, and we don't. Surely you don't think that every animal digests plants more efficiently than they digest meat? What about obligate carnivores, which can extract roughly 0% of the energy from plants?

You could measure by calories, since there will not be a huge difference in the number of calories consumed by people with different diets.

Giving an incredibly quick example, wheat and ground beef have roughly the same caloric density

Wheat: http://www.fatsecret.com/calories-nutrition/usda/whole-grain...

Beef: http://www.fatsecret.com/calories-nutrition/usda/ground-beef...

But since it requires numerous pounds of wheat to create one pound of beef, you are losing overall caloric density.

I can easily eat a 1/2 lb steak for dinner and feel fine, but eating 8 slices of bread at once will make me feel very sick. so I don't think caloric density is the be all and end all of nutritional value. I mean, wheat and beef also have about the same caloric density as gummi bears...

http://www.fatsecret.com/calories-nutrition/kroger/gummi-bea... https://www.google.ca/search?q=40g*11.3+to+lb https://www.google.ca/search?q=140*11.3

I consciously avoided any reference to ethics to avoid that quagmire. But unlike ethics and the effects of the complex series of compounds that are food on the complex system of tissue that is the body, the environmental economics of food are pretty much straightforward and as far as I can tell both well understood and lacking the ridiculous back-and-forth of nutritionism.

It's absolutely possible that many vegans are vegans due to some psychological pressure towards purity or ascetism, and they just coincidentally chose a pressure vent that also makes sense in an economic and environmental sense. I'm sure many of them might even be aware of that dualism.

What is interesting from a scientific point of view, and this is one subject we know a lot more about than actual nutrition, is why people who are otherwise scientific minded skeptics are superstitious when it comes to nutrition (if you believe that eating more green vegetable or less, consuming more vitamin C or less, more saturated fat or less is actually better for you, then you are superstitious, unless you are knowingly placing a scientifically unfounded bet on one diet over another).

There is certainly lots of superstition in all of our beliefs, but you overblown your thesis to the point of being a bit ridiculous...

First of all you present it as "all or nothing" choice, like either you had full knowledge from a scientific study or otherwise there would be absolutely no reasons to choice one alternative over the other. In the absence of absolutely certain evidence there are still more or less "probably good" choices given the informations we have and there are also heuristics that might be helpful.

You also assume that the only way to navigate nutritional choices is through statistical studies. There are other ways though, we have a decent understanding of the physiology of the human body and its biochemistry and we happen to know for example that the moving of waste products through the intestines is greatly helped by fiber consumption, so I don't think eating green vegetables is particularly superstitious.

With your point about "purity" you wander into psychoanalysis, which is rather funny considering your supposedly hyper-rational stance.

It's not all or nothing, obviously, but many people's dietary choices (especially those who consider themselves most health-conscious) go far, far beyond anything that's supported by science. My claim is that most dietary choices beyond a reasonable intake of calories and more or less "normal" food is magical thinking and worse -- it's pseudoscience. This includes what we know about human physiology. We know how some systems work, but we don't know much about how they interact. Suppose fiber helps to move waste through the intestines. But does it have other effects as well? Is it good overall? And suppose it is good overall -- just how good is it? Is it even worth the effort of consciously increasing your green vegetable consumption by 10%? This last point is the crucial one, because I'm trying to show that when it comes to food, some people actively change their behavior based on conjectures, or little evidence.

BTW, what I like most about John Ioannidis's work is that he not only proved theoretically that most medical research is false, but he showed it empirically: He showed that a large percentage of papers in the best regarded medical journal turned out to either be completely false, or to have a much reduced effect-size. Some of these papers suggested practices that, at the time, were considered "probably good" choices, and have since been shown to be anything but.

What I was saying about purity had nothing to do with psychoanalysis. Not all psychology and anthropology is psychoanalysis, and I suggest you take a look at Haidt's research. At the very least, it's thought provoking.

Lastly, I'm not taking a hyper-rational stance. I've long ago realized that I, like all people, am far from rational. I am superstitious myself, and about stranger things than food. I just think that the rise of the food religion among the educated liberal elite is interesting. I am very much interested in the history of religion and mysticism, and I always find it fascinating how magic works its way back into our lives -- contrary to Max Weber's assertion -- no matter our background. Haidt's theory of values is one especially interesting framework through which to examine this phenomenon.

> BTW, what I like most about John Ioannidis's work is that he not only proved theoretically that most medical research is false

"Proved" is being thrown about a bit liberally in connection with Ioannidis' work. It's certainly in dispute [1]

Either way, it seems your central point has a number of flaws. What you are attributing to superstition (e.g. consuming more leafy greens) is in fact more often than not rational decision making based on admittedly limited information.

Will the consumption of vegetables ultimately improve ones health? I don't know, let's take a more specific example. For instance, take someone interested in positively affecting their likelihood of developing diabetes. A quick google search turns up a study that notes a correlation between increased vegetable intake and a reduced risk of diabetes[2].

Of course, increasing intake of green vegetables may mean a decrease in some other substance. Another quick search turns up a research study documenting a link between increased fructose consumption and insulin resistance [3]. Thus, if I were hypothetically interested in positively affecting my insulin response, it would be quite logical to increase my consumption of green vegetables while decreasing my intake of sugar.

Is this course of action wrong? Possibly. However, it's certainly rational and not exactly "superstitious". You've defined the term so loosely as to encapsulate even such things as making rational decisions based on limited information. That is certainly not what superstitious really means. Certainly, someone who refuses to change their dietary habits despite ample refuting evidence could be classified as superstitious, but that's not a distinction you have made.

[1] http://www.technologyreview.com/view/510126/the-statistical-...

[2] http://www.eurekalert.org/pub_releases/2010-08/bmj-glv081810...

[3] http://www.nutritionandmetabolism.com/content/2/1/5

> What you are attributing to superstition (e.g. consuming more leafy greens) is in fact more often than not rational decision making based on admittedly limited information.

Perhaps I have not made my case clearly. Magical thinking has two parts: the first is being wrong (although that's not essential for magical thinking; it can be accidentally true); the second -- and this is what distinguishes magical thinking and superstition from mere false belief -- is its motivation to action. People believe many things that are wrong, but superstition is the false belief that changes their behavior.

My claim is that healthy food falls under the category of superstition, or magical thinking, because people so readily turn what you call limited information into action. What we may think of as "classical superstition", say fear of black cats, was also based on limited information. I'm sure there was plenty of evidence to suggest black cats are harbingers of bad luck. So, fearing black cats could be classified as rational action.

But fear of black cats, same as the healthy-food religion, is superstition precisely because it is a belief people accept based on lower standards of evidence than they would in other aspects of their lives, and at the same time motivates them to take action. Why? Because they want to believe it. It makes them either afraid or hopeful.

> I'm sure there was plenty of evidence to suggest black cats are harbingers of bad luck.

There were university publications on black cats being harbingers of bad luck? While it's hard to juxtapose what constituted an 'equivalent' level evidence during what are otherwise radically different historical time periods, this claim strikes me as stretching the analogy quite far.

> But fear of black cats, same as the healthy-food religion, is superstition precisely because it is a belief people accept based on lower standards of evidence than they would in other aspects of their lives

Multiple academic findings corroborating each other is typically seen as enough evidence upon which to base action. If not, then what constitutes adequate evidence?

Also, it would be helpful if you could point out aspects of peoples lives in which they generally behave according to your definition of rationality, or in which they maintain a 'high' standard of evidence.

> Multiple academic findings corroborating each other is typically seen as enough evidence upon which to base action.

There is little of that in nutritional research.

> Also, it would be helpful if you could point out aspects of peoples lives in which they generally behave according to your definition of rationality, or in which they maintain a 'high' standard of evidence.

I'll try, but first I'd like to point out that I don't think there's hardly any important decision people make rationally. I personally believe that people are utterly incapable of rational thought in all but the most emotionally-neutral of situations (and even when they are somehow able to think rationally, they are often unable to follow through with action), but that is a little beside the point.

People require an impossibly rigorous proof to sway their political opinions (you can call it the opposite kind of superstition. If healthy food is a new cult, politics is like an old, established religion).

Also economics and finance. Economics is also a highly debated field with about as much scientific rigor as nutritional research in its current form, and yet most people are much more careful about changing their spending habits -- or the economic policy they support, which brings us back to politics -- and certainly much less radically than their eating habits. Again, this may be superstition that causes inaction rather than action, but I think it's qualitatively different from our food superstition.

Raising children, too, I think, is different. I can't quite compare it to food (I haven't had the time to think it), but while there are many child-rearing fads, they somehow "feel" different from food fads. They feel more like fads, while healthy eating feels more like religion.

Sorry for not being very rigorous myself, but I'm just raising some things we can think about.

Steve Jobs seems to have indulged in a surfeit of magical thinking about nutrition. It might have killed him.

http://www.psychologytoday.com/blog/naughty-nutrition/201201...

Extreme fructose diet. The company was even named Apple.

This quote alone shows why the author has zero credibility:

"[...] environmental toxicity and genetic proclivities would have contributed as well. Certainly, Jobs was exposed over the years to massive bombardment from WiFi and other electromagnetic fields (EMFs)."

Digging deeper, it appears her career as an author and nutritionist is based on the idea that eating soy and vegetarianism is bad for you. Correlation is not causation, but it has long been known that vegetarians live longer.

I'll put more faith in peer-reviewed scientific journals than an author who writes in a magazine called "Psychology Today."

I really like your analogy to unit tests and integration tests. It makes me wonder if the Soylent ‘experiment’ might provide a better means to do that. Rob has already written about a few times where he was missing something in his formula and was able to detect specific problems and respond to them. Sounds pretty close to being unit-testable at that point.

I really dislike the unit test and integration test analogy. It is based on the assumption that the human body has something in common with a computer program - or anything man-made for that matter. This is clearly not the case. We tend to think of ourselves in terms of whatever our current lead technology is. It has been like that before [1]. While it is certainly psychologically comforting it becomes dangerous when we act based on what really is somewhat of an arbitrary model.

[1]: http://webadventures.at/2007/06/17/der-mensch-als-industriep...

It's based on the assumption that the human body is a complex organism made up of interacting subsystems, and that there is a distinction between testing the effect of a change on one subsystem and testing the effect of a change on the entire organism. That's a very abstract assumption, and easily applies in this case. If you can't see anything in common between the human body and a computer program, you're just not looking at an abstract enough level. You can start with "they both exist" and work your way towards the concrete from there.

> We tend to think of ourselves in terms of whatever our current lead technology is. It has been like that before [1].

This is what we call progress. Technology doesn't grow on its own, it embodies the deep insights into workings of reality humans gain throughout the century. Therefore it is to be expected that we will draw parallels and that they will improve as we improve our tech.

There is no way anyone can make several accurate observation about nutrition at our current stage of knowledge about physiology, let alone be able to "hack" it. It's like someone saying they're working on a warp drive or a teleporter. It could happen some day, but probably far in the future.

Actually, the warp-drive/teleportation problems might be easier, because we'll probably know when we get there. With nutrition, there's little evidence to suggest that a theoretically perfect nutrition would result in much improved health over sub-par nutrition. We don't even know that nutrition has a strong effect on health at all (other than eating poison, or few other truly well-known facts).

There is no way to make accurate observations about nutrition? Well shit then, I guess we'd better just give up and accept our inevitable future obesity.

Well, maybe. Research into obesity has been going on for decades in many countries without clear cut conclusions. On the other hand, tackling obesity alone is a different matter from finding food that makes us healthy. There might be some hope, yet. While we don't know that food can make us healthy, it's quite probable that it makes us fat or thin, or, at the very least, has a significant effect on weight.

I think you're too loosely using the terms "superstition" and "magic".

This is Merriam-Webster's definition of superstition: 1 a : a belief or practice resulting from ignorance, fear of the unknown, trust in magic or chance, or a false conception of causation b : an irrational abject attitude of mind toward the supernatural, nature, or God resulting from superstition 2 : a notion maintained despite evidence to the contrary

There are indeed diets that are superstitiously motivated (don't eat pork because it's an impure animal, don't eat cows cause they're sacred, etc), but you're throwing everything in the same pot, liking religious motives and decisions by rational minds to eat or omit certain food items, based on observations and deductions (albeit sometimes limited and flawed) of effect and causality. If anything, the latter is but an attempt at building a framework toward a saner nutrition.

If we were to listen to you, we should wait until everything has been discovered about food and physiology to start making up our minds as to what is good or bad to ingest. At which point I guess what you keep calling "magic" then becomes science. This tendency of wanting to be absolute is a bit naive. No body of knowledge works like that. Just because our understanding of a topic is patchy, doesn't exempt some connections to be made that can be built upon to stitch up a gradual and more complete understanding. Which, if I observe how nutrition has evolved, is exactly what's happening.

Nothing magic there.

I have chronic life threatening illnesses. I've had equal numbers of good doctors and bad doctors. I'm deeply skeptical. It's wicked hard for me to figure out what's going on in my body. And self-reporting is notoriously unreliable.

Until science catches up, I think we should all "try and see", compare notes, and keeping searching until we find solutions. I've been patient advocate for many others; this is old advice.

---

About two years ago I tried the Four Hour Body strategy. My goal was to lose weight. I was astonished when my psoriasis started to clear up. The important part: I established cause and effort by stopping the nutrition (bad eating during business trips) and the psoriasis comes back with a vengeance. I have no idea why it works. Because I'm eating more veggies? Because I'm avoiding wheat? All I know is it works.

Since then, I've had steady improvement while sticking to the troglodiet (tm), resumed eating meat and lotsa more of veggies. More or less following Dr Terry Wahls "Minding your Mitochondria" strategy, with occasional treats (cheesecake!) so I don't go insane.

Most recently, my gf persuaded me to try her naturopath doctor. From prior experience, I think naturopaths are quacks at best. But I also think that the good bits of naturopathy will eventually just be called "nutrition".

I presented specific complaints to this ND, which my other doctors haven't been able to assist with. I'll give an non-embarrassing example. My muscles never relax. I'm now super tone without exercising. It's fantastic. But I also have zero energy. I've been taking magnesium. I've seen a neurologist. I've tried some other stuff.

So the ND says the magnesium isn't getting to my muscles because I'm not eating enough essential fatty acids. Tells me to eat more of such and such and take some pills. Sure, why not, can't hurt.

Similar story for the other conditions I have.

Well, I'm about a month into this new regiment. Huge improvement on one issue, modest improvement on two others, and no change with the fourth.

In a few more months, I'll stop the regiment, see if my conditions get worse. I don't want to be taking pills and such without benefit.

---

I agree with everything you've written, but we should continue to experiment and ask questions, until we find solutions.

I really would like to have links to the studies mentioned, the most interesting one I could find is:

http://jama.jamanetwork.com/article.aspx?articleid=205797 — 2007, Cited by 1214

  Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. 
  The potential roles of vitamin C and selenium on mortality need further study

Who would have guessed eating too much of something could be bad for your health</sarcasm>

Somebody should tell Kurzweil about this.　"Kurzweil does not believe in half measures. He takes 180 to 210 vitamin and mineral supplements a day, so many that he doesn't have time to organize them all himself." http://www.wired.com/medtech/drugs/magazine/16-04/ff_kurzwei...

About these supplementary pills I think the advice of Taleb is very good:

- When there is a very strong reason to medicate or do surgery, do it immediately.

- When it is just for convenience, don't do it. The long term risks are unknown.

His diet advice is "don't ingerate anything that has been invented in the last 50 or 100 years", so wine: yes, Coke: no, vitamin pills: no, etc.

However in case of a cancer with a very bad diagnostic, he would try even the newest unverified cure.

I think this advice should be heard in the US where so many people seem to fill their stomack with aliments that did not exist 50 years ago (processed food, chocolate bars, soda, pills being the worst).

(I am rephrasing)

Can you link to where he says that? I'd like to read more, it sounds interesting.

Also, coke (both the drug and the soft drink) is well over 50 years old, but I understand the point you're getting at with being wary of consuming substances that are not well understood.

On a side note, some people who argue in favour of legalising cannabis are also argue in favour of legalising cocaine, as they reckon keeping it illegal does more damage than legalising it (Mexican cartels). In places like Bolivia, people chew coca leaves as a natural stimulant (cocaine comes from processed coca leaves). I'm not sure where I stand on legalising cocaine though, I can see two sides to the argument.

I read this in his Antifragile book.

Thanks, I've been thinking about buying it, this gives me the excuse I need :-)

He's basically been doing the paleo diet (and the associated exercise, short duration sprints and weight lifting) for a while now. It doesn't seem hugely compelling to me, except for the reduction of all the excess carbs that come from a modern diet, which is a really good idea. (Pretty much everyone except the nutty nutrition skeptics - have a smoke, correlation isn't causation guys! - in this thread would categorize that as a win.)

In his recent book AntiFragile, Taleb states that he drinks no beverages that aren't at least 1,000 years old. In particular, he admits to drinking coffee, water and wine.

Ahh, yes! The further we go from nature, the more problems we create for ourselves. The Taoists are right.

A taoist would say that everything is "natural" , including man-made vitamins, cars and chemical plastics.

No I wouldn't. If this were the case, it wouldn't be possible to depart from the Way.

Ancient Taoism, ie. the real deal, emphasized living as simplistically as possible and eschewed such novelties. It later became politicized as a court tradition around the emperors of Ancient China, and underwent significant modification. It is this latter period from which much of the surviving literature derives - a common historical trajectory to most ancient philosophies.

Although there may be some truth in that, even things found and used in their natural state can be problematic, such as coal.

Taoism emphasizes locality. So if you have coal at your place and burn it, so be it. If you have no coal, use wood instead. Many people in the modern world, so far from nature, are unaware that the emissions from burning locally sourced wood for heat and cooking are actually very low... making it more attractive than other energy sources for these purposes, as long as you have some and a bit of time to collect, chop and maintain it. Transportation overheads are removed, fuel grows itself. Win. If you have no wood and no coal, be one with the natural cold :) http://nepacrossroads.com/fuel-comparison-calculator.php (Excepts transportation/purchasing overheads)

We may have created problems for ourselves, but life expectancy doesn't seem to be one of them.

The Guardian recently ran an article on the same subject:

http://www.guardian.co.uk/lifeandstyle/2013/jun/07/vitamins-...

Its longer than the NYT article and contains some interesting links to clinical trial results.

It's written by the same author!

It is nearly impossible to know definitively what to eat, but it seems like a reasonable approach is to: eat lots of organic vegetables, some organic fruit, limit meat intake, and perhaps take some vitamins.

It drives my wife crazy (because she is pro-vitamins) when I take specific vitamins just 2 or 3 times a week. I have a weekly pill dispenser and I randomly put in 2 or 3 each of vitamins E/D/C, and Coq10, calcium, magnesium, etc.

My thinking is that we evolved as hunter gatherers and we would not get the same nutrition every day, so why not mix it up a bit in modern times? I am fairly sure that I get what I need from my diet (I am a card-carrying food junkie; my food web site: http://cookingspace.com) but taking small random amounts of vitamins during the week maybe helps. Who knows. I think that it is as important how you eat (i.e., eat very slowly, appreciate the food) as what you eat.

> eat lots of organic vegetables, some organic fruit

"Organic" is an unscientific ideological term. It has absolutely nothing to do with the nutritional quality of food. Study after study has shown "organic" food to be nutritionally equivalent to scientifically farmed food, including quantities of pesticides found on them.

(Yes, citation needed but I don't have refs in front of me right now)

You should talk with my pet Parrot. If we give him non-organic food, he doesn't much like it. My wife and I agree: organic tastes better. I can not scientifically vouch for it being better for you, but I am very certain that it tastes better.

My Dad is a member of the National Academy of Science and he used to roll out the "no proof" argument. My argument, which he eventually accepted and he now eats organic:

1. it really does taste better

2. what can it hurt to eat locally grown organic food? Is it worth a small amount of extra money, just in case it is better to eat food not grown with petroleum fertilizer?

Anyway, make up your own mind.

I used to get really bad headaches like every other day.

One extra busy and strange week I forgot to take my multivitamin a few days in a row.

And it dawned on me my headaches went away.

Now I've stopped taking my multivitamin for a year and I've only had headaches I can count on one hand.

Tried another brand multivitamin and same headache problem happened so I'm done with that.

I wonder whether it was a specific component, and if yes, which.

That was my thinking too but there are so many things in them, doing it scientifically would be quite a feat and not sure how to go about it.

For all I know it might even be the inert compound binding it.

Might be the Vitamin B, anecdotally I've heard some people getting headaches from high doses of it.

It is one of the known possible side-effects of vitamin B3, but I have no idea how common or at what doses.

> Please log in.

Can we do something about paywalled links here, please? This is the 5th one on the front page today.

Does incognito mode still work to get around the NYTimes' paywall?

For me, yes. When they say "You have passed the maximum reading limit", it's incognito-time

Perhaps someone can help you with that, but I'm not logged in, have never logged in, don't intend to register, and don't get the "Please log in" message.

I wonder what's different between your setup and mine.

In order to access our Web site, your Web browser must accept cookies from NYTimes.com.

In that case, I have no interest in any of their articles.

Why are you afraid of cookies? The cookie monster, maybe. But cookies, no!

I use Firefox. In Firefox it's easy to "clear history when Firefox closes". That includes cookies.

So all you do to be as close to anonymous as possible is: 1) set FF to clear cookies on close (this is my default) 2) close FF 3) open FF, go to nytimes.com 4) when done reading, close FF

That's it. All my cookies get deleted before and after I use the web site. I fail to see any harm in allowing the Times to set as many cookies as they want to for the duration of my browsing session with them. I even allow third party cookies. I don't care, they're all gone as soon as I exit my browser. BTW to combat sleazier sites I also use the Better Privacy addon. That can easily be set to clear out Flash cookies every time the browser exits.

One other thing. Use NoScript. Don't whitelist NY Times. Then you will never be bothered in the slightest by their paywall; it relies on JS.

A private browsing window is another solution to this problem. I use it frequently! :)

The cookie monster only goes after people with lots of cookies, especially when they don't even realize they have them.

Unfortunately, there's still no NoScript for Chrome :(.

With NYTimes, I find if I add ?_r=0 to the end of the url it works.

So... should I take a daily multivitamin or not?

No, you should have a balanced diet instead.

Eat food. Not too much.

Hypothetically, let's assume that I don't eat vegetables but once a week. Should I take a multivitamin daily?

Why do you eat so little vegetables?

Why not both? Better yet, why not try to figure out[1] what you're deficient in, and supplement that (either by diet, or supplements as needed)?

It is silly to just assume everyone has the same dietary needs and can be given broad, vague advice like "eat a balanced diet", when that could easily be a full-time job itself and all that might actually be lacking is just a few micronutrients, or just have a subtle intolerance to something that needs to be removed from your diet. These problems are not as uncommon as you may think, and there is too much variation to not only suggest one 'fix-all' solution, but to assume that one can even be had right now. Learn about your specific needs and treat those; don't go off of random anonymous internet comments or bloggers looking for page views.

[1] One possible way to do this: http://www.spectracell.com/patients/our-tests/patient-micron...

For most people who eat correctly, taking Vitamins is more of a placebo than anything. I tried to start the discussion about it in scientific subreddits many times and got shut down. Vitamins are used way more than homeopathy and do works in many cases so it's hard for people to understand that it doesn't do anything, and might actually harm you if you take too much, if you're eating normally already (well in most cases).

For what it's worth, regarding the multivitamin and prostate cancer study: http://www.rayandterry.com/blog/prostate-cancer-and-vitamin-...

This is a bit disingenuous.

Top title: 'Don’t Take Your Vitamins'

Base : 'As a result, consumers don’t know that taking _megavitamins_ [...]'

♫♫ One of these things is not like the others. ♫♫

If the advice is just don't mega-dose the things, well - duh. The things even have warnings to that effect:

http://i.imgur.com/5bS4gl2.jpg

Right there on the tube - 'do not exceed the recommended daily dose.'

I take that advice to be fairly uncontroversial. Lots of things are going to kill you if you take too much of them. Just don't be a bit silly and expose your body to really high levels of things that it'd never get anywhere near in nature without doing the research first.

I suspect that people don't think it's particularly risky because it's so concentrated - if they had to sit down and eat their way through packets of much less concentrated pills maybe they'd start to worry about loading their systems with so much stuff. :/ -shrug-

oh New York Times, always a fine reading in the Sunday morning, in fact very interesting. Just to show what lobbyist and the private sector are willing to do, in order to stay in business.

So should I take vitamins or not?

The vitamins that most take provides fractional amounts of the RDA -- at most 100% (e.g. Centrum, etc.) -- and is truly intended to be an offset of an imperfect diet. Using the case of mega-doses, especially against compromised peoples, as the demonstration of the dangers of normal supplementation is dishonest, just as it wouldn't be reasonable to discourage water consumption through the example of someone consuming tens of gallons a day.

I am not speaking of this specific author, a very respected researcher, however there are many who essentially make bank on the anti-vitamin bandwagon (never underestimate the motivation of getting broadly quoted and referenced, which is a likely outcome when you "prove" counter-intuitive conclusions), and the techniques are often highly dubious.

One of the most common tactics to discourage vitamin use is to compare the mortality of general vitamin supplementation users and those who don't, ignoring the immense self-selection bias that comes into play. Namely that people in compromised health or at risk often flock to vitamins -- wrongly -- as a snake-oil fix for ailments, thus providing plenty of data in the "mortality" side.

I take the odd multi-vitamin, primarily on days where I know I've eaten terribly. I do supplement Omega 3s daily.

I used to take daily Centrum. Had a few years where my liver enzymes (AST/ALT) were elevated. Doctor asked if i took a multivitamin to which I told her I did. She said stop taking it. That was about 8 years ago and I haven't had an elevated liver enzyme test since then. She said some people have a really hard time processing all those vitamins in their system and it hurts their liver.

Now I just take Vitamin D (tested as mildly deficient) and Omega 3 from krill.

Makes sense, especially given the fluorescent yellow urine that often comes shortly after taking a vitamin (the liver/kidneys working hard to eliminate something, which is telling enough). It seems like vitamins would be improved to come in smaller, multiple-doses (though that becomes less convenient) -- the one I occasionally take is dosed as two pills through the day to hit the 100% mark, and it has removed the nuclear pee response -- or slowed delay, etc.

The fluorescent yellow is usually specifically due to high doses of vitamin B2, and is because vitamin B2 is orange. It's not by itself an indication of a problem.

Some of the B-vitamins can have nasty side effects in huge doses, but those doses are far above the RDA for most people.

EDIT: Note that "huge doses" are still within range of quite a few "megadosed" vitamin supplements. I've experienced annoying side-effects from vitamin B's as a lot of pre-exercise products have high doses as it is believed to have an effect on energy levels (I don't know if the science stacks up or not), but "neon pee" occurs with very low doses of B2 and is by no means an indicator you'll run into any of the other side effects.

It has nothing to do with your organs trying to eliminate something but with B vitamin complex natural coloring. Your body only absorbs what it needs and the rest is excreted.

Read Ben Goldacre's Bad Pharma. http://www.amazon.co.uk/Bad-Pharma-companies-mislead-patient...

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