Thorne Research rebuttal to article: “Dietary Supplements and Mortality Rate in Older Women”

October 17, 2011

To Thorne Research’s valued medical practitioners and their patients:

A recent study, “Dietary Supplements and Mortality Rate in Older Women,”
published in the Archives of Internal Medicine, 2011, Volume 171(18):1625-1633,
has caused some concern among the public about the safety of dietary
supplements. We have thoroughly reviewed this study and share the following
analysis in order to help you better understand the study’s design and its
findings, and to help allay any concerns you may have.

The Study’s Design
This study is an analysis of data gleaned from 38,772 postmenopausal
Caucasian women enrolled in the then-ongoing Iowa Women’s Health Study.
The data for the study is based on the responses obtained through a selfadministered
questionnaire initially distributed in 1986, with two follow-up
questionnaires distributed over the next 18 years, in 1997 and 2004. The
questionnaires inquired about lifestyle practices, food intake, dietary supplement
use, weight, smoking status, hormone replacement therapy, and the presence of
diabetes or heart disease.

Although study participants were asked about their intake of dietary supplements,
the study did not report how much of any specific nutrient was consumed. Nor
was information elicited from the women regarding the chemical form of the
supplement (e.g., picolinate versus sulfate) or the quality of the supplements that
were taken. Furthermore, although the women were asked whether they took a
“multivitamin,” the study does not define this term; i.e., the mineral, vitamin, and
botanical content of the study’s universal “multivitamin” cannot be determined.
Finally, no attempt was made to verify the accuracy of the answers provided in
the questionnaires, nor were any of the participating women asked why they
were taking supplements, and no attempt was made to determine the impact of
taking—or not taking—supplements on any specific individual.
One possible flaw to consider. It is well known that when an individual is
diagnosed with a serious disease, such as cardiovascular disease or cancer,
beginning or increasing the use of dietary supplements occurs commonly. If the
new or increased supplement use were reported on a questionnaire, and then
subsequent mortality resulted because of the underlying disease, the situation could very possibly exist such that the individual’s death, while properly attributed
to the disease, would also be “associated” with the use of a dietary supplement.
Such an erroneous scenario is a highly likely flaw in the study’s design.

The Study’s Findings
The results of the study’s analysis claim to show a slightly higher risk of all-cause
mortality associated with the use of multivitamins, iron, and copper. In weighing
the study’s findings, however, it must be emphasized that the Iowa Women’s
Health Study is a retrospective study of already collected data. It is not a
prospective, controlled intervention study, i.e., it is not a “clinical trial,” in which
participants would be given a specific dietary supplement or a placebo and then
followed closely over time to observe not only the specific outcomes but also the
factors possibly contributing to those outcomes.
As can only be surmised retrospectively, individual circumstances change over
time, and a significant number of the women participants likely either changed or
began new dietary supplement regimens over the course of the 18 years they
were studied. And since there was no direct contact with the participants outside
of the mailed questionnaires, general information surrounding individual deaths
had to be obtained from public records; it was not ascertained by direct medical
investigation.

With regard to iron and copper, it has been known for decades that both metals
can be potentially toxic, as exemplified by the multi-system disease states that
can result from hemochromatosis and Wilson’s disease, respectively. For this
reason, many postmenopausal women, like men, probably should not take an
iron supplement in the absence of anemia or a documented deficiency. At the
very least, iron and copper supplements should be taken concurrently with
antioxidants and/or antioxidant-rich foods to prevent a potential increase in
oxidative stress. Each of these circumstances points to the merits of dietary
supplements being recommended and overseen by medical professionals.
With regard to multivitamins, there is simply insufficient data that can be gleaned
from the study to make any serious conclusion about the impact of multivitamins
on mortality. This is due to the fact that there are literally thousands of different
combinations of vitamins, minerals, and botanicals that can be considered a
“multivitamin,” as well as a whole host of considerations such as quality, potency,
dosage, protocol, and indications for use, among others.

Practitioner and Patient Concerns
We believe there are serious flaws in the methodology, analysis, and findings on
which this study is based. Retrospective surveys such as this—in which people
are asked to recall years of dietary habits or supplement use—are notoriously
inaccurate. The only conclusion that can realistically be drawn is that a slight statistical association was found based on a limited data set of questionable
reliability—and a simple association does not reflect causation. The study’s
authors do not disagree, stating the following in their commentary to the study:
“It is not advisable to make a causal statement of excess risk based on
these observational data…” We heartily agree with this advice.
When made by a quality manufacturer, when recommended by a knowledgeable
health-care practitioner, and when taken for the appropriate indication, dietary
supplements promote, enhance, support, and help maintain overall good health
and well-being. The “results” of the recent study do not diminish this conclusion.

Alan Miller, ND Robert Rountree, MD
Director of Medical Education & Research Chief Medical Officer
Thorne Research, Inc.

For further commentary on this study:
The Alliance for Natural Health
The Council for Responsible Nutrition

Introducing Ali

Hi! I’m Ali: wife, mom, photographer, and self-diagnosed greenoholic. (and sister-in-law to the beautiful and very talented Dr. Carolyn).  I will be writing on the Foundations Family Wellness blog from time to time about my own experiences and findings in my path to a cleaner life.  I am not a doctor, or a chemist, or an environmental engineer;  anything I write is solely based on my own experiences and my own research.  Here is my story.

My husband and I have cleaned up a few things in our life here and there over the years, but nothing too over the top.  A couple of years ago, Carolyn told us about the BPA in the Nalgene bottles/plastic water bottles and Tupperware type containers.  Naturally I took the calmest option and threw away pretty much everything plastic in our kitchen!  That was certainly fun, considering that my husband and I are also wateroholics (made up words are a necessity from time to time) and are rarely seen more than a few feet from our water bottles. 

The year after that, Carolyn informed us about the Environmental Working Group website and the problems with sunscreen and personal care products.  Same thing again-- the most rational and calm reaction was to throw away ALL the sunscreen we had and half of my makeup.  Ugh.  Wouldn’t recommend. (also a Sephora-aholic) 

Almost two years ago, another friend turned me on to Nina Planck’s book, “Real Food For Mother and Baby” and luckily that time I didn’t throw everything out, but my diet and the food that I buy hasn’t been the same since.

The big push came when my daughter was about 9 months old and some stupid dramatic thing was going on with the government.  I woke up one day and thought, “well, if I can’t leave behind financial and governmental stability for her, then maybe I should think about at least trying to leave her some clean earth and her health by doing little things that I have power over.”  My goal is to be around for as many days of my daughter’s life as I can possibly manage, and if that means going a little green-nutso, I at least have to try.  (And yes, I’m fully aware that anything could happen tomorrow, but today feels much better knowing that I’m doing everything I can to have the cleanest, healthiest, and happiest home I can manage.)

Within a week of that realization we were full-time, cold turkey cloth diapering! (Thanks to the wonderful ladies at Diaper Junction!!)  Everything has snowballed from there and I feel like we’re already different people living in a different world.  Through a special “Healthy Home” party hosted by a friend, I discovered the book Healthy Child, Healthy World.  This book has opened my eyes more than any other book I've come across and I’ve been able to easily increase my “cleaning up my life” efforts using their research and tips.  

Please come back for recipes for homemade cleaning and personal care products, book reviews, how-tos, and condensed versions of interesting research I stumble across!!

Remember:

'A journey of a thousand miles begins with a single step."  -Lao Tzu (or Confucius)

Cold Weather Beef Stew

The change of the seasons from summer to fall means it's time to start breaking out the Dutch ovens and Crockpots to make those great nourishing one-pot meals that will fill your family's tummies and warm their hearts without breaking the bank. The great thing about soups and stews is that these meals make it easy to eat produce that is in season and they contain lots of immune-supporting ingredients in them, as well.

Here is a recipe for beef stew I made that was a modification of Martha Stewart's version.

Ingredients:

3 pounds lean beef stew meat, cubed and trimmed of fat
1/2 cup flour (you can use Bob's Red Mill all-purpose gluten-free flour if desired)
1 teaspoon ground sea salt
1 teaspoon fresh ground black pepper
olive oil

2 medium-sized yellow onions, sliced into quarters
6-7 cloves of garlic, peeled and smashed with knife
3 carrots, sliced into large chunks
4 stalks celery, sliced into large chunks
8-10 yellow dutch potatoes, sliced in half (or kept whole if small enough)
2 bayleaves
1 tsp dried thyme
1/3 cup tomato paste
3 tablespoons balsamic vinegar
2 cups no salt beef broth
2-3 cups water

Fresh parsley
Fresh grated Parmesan cheese

Preheat oven to 350 degrees. In a bag, combine flour, salt and pepper. Add beef cubes and coat with mixture. Heat several tablespoons on low in a cast iron pan and add coated beef a few pieces at a time, browning each side. Transfer meat to 2 quart Dutch oven. Add a little more oil, and brown onions in drippings. Transfer onions and all pan drippings to Dutch oven. Add the rest of the ingredients, adding enough water to about 1 inch below ingredients. Cook on stove over medium heat until liquid begins to boil. Transfer to oven and cook for 2 1/2 hours, then turn down oven to 200 degrees for another hour to really tenderize the meat. Scrape the sides of the Dutch oven occasionally during the cooking process.
Top with fresh parsley and fresh, grated Parmesan cheese. Salt and pepper to taste.

Serve with green salad, cornbread, and honey-lemon butter.

Here's a link to a wonderful gluten-free cornbread recipe:

http://www.celiac.com/articles/853/1/Cornbread-Deluxe-Gluten-Free/Page1.html

Recipe for  honey-lemon butter:

Whip 1/4 cup softened butter with 2 tablespoons honey and 2 teaspoon fresh lemon juice together. Refrigerate until ready to use.

Enjoy!

Healthy Bodies, Healthy Choices, Healthy Environment

Every day we make choices about the food we eat, the clothes we wear, and the places we go. In a world of convenience,  we are also presented with a multitude of choices in the products and goods to buy that can help us keep our households and yards looking sparkly clean and free of pests, or that make our skin look blemish and wrinkle-free. Unfortunately, the ingredients in these products, while they may be effective in the action they are purported to perform, can actually be very detrimental to our health.

Envision for a moment your body as a bucket that fills up with exposures to the various chemicals in the environment. In a healthy body, the liver, kidney, gastrointestinal system, lungs, skin, and other organs are able to effectively process and eliminate these chemicals. However, as the bucket gets more and more full with these chemical exposures, these organs of elimination get overwhelmed with the shear volume of work they must do. Eventually they may no longer be able to keep back the tide of chemicals entering the body. As the bucket overflows, symptoms may develop, including skin lesions, chronic allergies, body aches, fatigue, intolerance of odors, and many other symptoms.

Part of helping keep your "bucket" from overflowing includes using your buying power as a consumer to choose products that contain more natural ingredients. Thankfully, there are many resources available to the savvy consumer to quickly decide which products have a better profile related to their impact on the body and the environment.

The resources listed below will be part of a growing list of books and websites that can assist you as an informed consumer of healthy products. 

1. http://www.bodysense.com/Default.asp

This website is great for choosing personal care products with reviews by parents and other consumers.

2. http://healthychild.org/book

 A great book for making choices that can keep your children healthier from conception to birth and beyond, including how to reduce the chemical impact in your household.

3. http://www.ewg.org/skindeep/

The Environmental Working Group's website to compare the chemical ratings of over 65,000 personal care products.

4. http://www.nrdc.org/

The Natural Resources Defense Council has tons of information on current environmental issues, as well as how to reduce chemical exposures in your daily life... from school, to work, to home, and throughout all life stages.

5.  http://www.foodnews.org

This is the Environmental Working Group's shopping guide to "The Dirty Dozen" produce that will help you to choose foods that have been grown with the lowest amount of chemicals.

6. http://www.eatwild.com/

Eat Wild is a great resource for finding grass-fed animals in your area to ensure great nutrition for healthy bodies. They also have some good information on the health benefits of eating grass-fed animals.

7. http://fluoridealert.org

The Fluoride Action Network is a helpful resource for education about the health effects of fluoridated drinking water. Excessive fluoride consumption has been linked to numerous health consequences, including major effects on the thyroid gland, the pineal gland (responsible for immune regulation), and many others. Filtered, reverse osmosis or distilled water will be your best bet to avoid fluoridation, as well as the plethora of other chemicals, drugs, and hormones found in tap water.


As you make your daily choices about what products you use and the foods you consume, be gentle with your bucket and give it a little break by filling it with the good things already found in nature. The health of you and your family is truly in your hands.